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Based on medical record review, the medical staff were not accountable for the quality of care provided to Patient #1, specifically for failing to ensure that an abdominal binder was included in Patient #1's discharge orders.

Findings:

Review of Physician Order dated 12/24/12 at 1158 revealed abdominal binder at all times.

Review of Physician Discharge Orders Form dated 12/24/12 revealed Patient #1's discharge date is 12/27/12. Does not need 24 hour nursing, resume all previous orders medications via tube. Resume all as needed and over the counter medications via tube. Activity as tolerated and resume all therapies. New orders as follows:
- Tube feeding Isosource 1.5 with fiber 250 cc three times a day, flush with 50 ml water before and after each bolus. If Isosource not available use Boost Plus.
- Complete blood count and basic metabolic panel once a week.
- Patient has lung nodule, need repeat CT of chest in three months.

Review of Physician Discharge Summary dated 12/24/12 at 0943 revealed discharge instructions included CT scan in 2-3 months of the chest to rule out malignancy. If Patient #1 is having symptoms of weight loss or any other sign of malignancy, PET scan should be obtained. If necessary, a pulmonology consult can be obtained.

There was no evidence in the medical record that the abdominal binder was to be discontinued upon discharge. There were no instructions for use of the abdominal binder on Patient #1's discharge paperwork.