HospitalInspections.org

Based on reviews of policies, medical records, interviews with staff and physicians, the facility failed to provide nourishment to patients in the emergency department (ED) who were waiting on admission beds for 2 of 3 ED patients (#2 and #8)

The findings include:

Review on 08/23/2017 of policy titled, "Dietary, Ordering Meals and Checking Trays," did not reveal a specific policy statement related to feeding patients in ED.

1. Review on 08/23/2017 of Patient #2 revealed a 59 year old male arrived to ED on 06/06/2017 at 1349 for shortness of breath. Medical history is significant for insulin dependent diabetes. Further review revealed patient was admitted by the hospitalist at 1549. Pt #2 remained in ED until 06/07/2017 at 0830 (18 hours and 41 minutes) waiting for floor bed. Medical record review did not reveal any evidence of patient being fed while in the ED.

Review of physician orders dated 06/06/2017 at 1905 revealed a diet was ordered to begin at breakfast on 06/06/2017.

Interview on 08/23/2017 at 1350 with hospitalist revealed a diet was ordered for patient. Interview revealed meals could have been given to patient with this order. Further interview revealed incorrect date was placed on diet order. Interview revealed Patient #2 should have been fed in the ED.

Interview on 08/23/2017 at 1445 with ED nurse #1 revealed "If diet is ordered, I would definitely serve patient. I did not see the order for the tray. Not a lot of patients are kept overnight."

Interview on 08/23/2017 at 1010 with Director #1 revealed "I remember this patient. I transported patient upstairs to his floor bed. He was focused on not getting a meal tray. I don't think he got a meal while he was in the ER. We usually don't have patients staying overnight. This patient should have received a meal tray or deli box."

2. Review on 08/23/2017 of Patient #8 revealed a 60 year old female arrived to ED on 07/24/2017 at 1729 for chest pain. Further review revealed the decision to admit was at 2207 and Patient #8 remained in ED until an inpatient bed became available at 0756 on 07/25/2017 (9 hours and 27 minutes later). Medical history is sigificant for insulin dependent diabetes. Further review revealed no nursing documentation of meals served or consumed.

Review of physician orders dated 07/25/2017 at 0014 revealed diet orders of Consistent carbs 1500-1800 AHA (American Heart Association) low fat.

Interview on 08/23/2017 at 1010 with Director #1 revealed no documentation of meals served. Further interview revealed this ED patient should have received meals during ED stay. Further interview revealed the patient was a diabetic patient and should have been fed.

NC00128708