HospitalInspections.org

Based on interviews and document review, it was determined the facility failed to provide care in a safe setting by utilizing video monitoring of patients with a "baby monitor" without providing training or guidance to staff members.

The findings include:

The medical record for Patient #1, including nursing notes written by Staff Member #12, an RN, were reviewed on 12/6/21. Staff Member #12's nursing note dated 9/28/21 documented, Patient #1 was having "more frequent episodes of increased confusion along with hallucinations, including hearing music, people arguing and seeing a mouse in the bed." Patient #1 was also pulling off the oxygen and pulling at the IV therefore "mitts placed and camera set up for patient safety. Call bell in reach and bed alarms on."

In an interview with Staff Member # 12 conducted on 12/7/21, Staff Member #12 was asked to recall the actions taken by nursing staff on 9/28/21. Staff Member #12 stated, "I remember [Patient #1] was getting more confused and hitting [his/her] arms and legs on the railing of the bed. I'm not sure about the bruise under [Patient #1's] breast. We put a baby monitor (in the room) for [Patient #1]." Staff Member #12 stated, responsibility for responding to the baby monitor was "not assigned" and it was placed at the desk where, "someone is always there and we are all responsible."

On 12/6/21 the Surveyor was taken on a tour of the facility. The Medical Telemetry unit (MTU) contained 40 (forty) private rooms with some, "not all of them equipped with video monitoring, for the others we use a baby monitor," stated Staff Member # 12 The Intermediate Care unit (IMCU), contained 10 beds.

The Surveyor requested to review documentation of staff's training in video monitoring of patients, the policy and/or procedure on video monitoring of patients using a baby monitor, and a policy and or procedure related to provider notification of concerns while monitoring a patient via baby monitor.

At the time of the survey, the facility failed to provide documentation related to training of staff, including proper use of this type of device, the procedure for notification of the provider in the event of a properly identified patient concern, while using the "baby monitor". The facility was also unable to present a policy or procedure on the approved use of this type of monitoring device, who is responsible for monitoring patients via this device, and what are the documentation requirements of observations.

The policy provided, "Photographing, Recording or Filming Patients or Culpeper Medical Center Workers", states in part ..." the patient may be video monitored to assure safety and prevention of harm". The policy does not address the type of monitor.

During the interview conducted on 12/7/21, Staff Member #11 admitted, "we have some work to do regarding monitoring the patients."