HospitalInspections.org

Based on observation and interview the facility failed to ensure a sanitary and clean environment related to the storage of radiology equipment used in the Operating Room.

The findings included:

Observation on February 4, 2013, at 2:45 p.m., in the hallway outside of the post recovery unit for endoscopic patients and the Operating Room hallway, revealed one C- Arm machine (used for x-rays in the operating room), stored uncovered in the hallway. Further observation revealed two chairs sitting beside the machine.

Interview on February 4, 2013, at 2:45 p.m., with the Operating Room Nurse Manager, in the hallway, revealed "...the machine is stored in the hallway and before it is taken into the operating room, we clean the machine...patient's families sit in the chairs while the patients are recovering..." Further interview with the Nurse Manager confirmed the C-Arm machine was not covered, visitors and staff often pass by and sit in the chairs beside the machine and the C-arm machine is used in the Operating room.

Interview with the Administrator on February 5, 2013, at 3:00 p.m., in the conference room, confirmed the C-Arm machine was to be covered while in the Operating Room hallway.

Based on observation and interview, the facility failed to ensure drugs were secured and labeled in the Operating Room and in the Nuclear Medicine Room.

The findings included:

Observation on February 4, 2013, at 2:30 p.m., in the Operating Room (OR) #2, revealed one unlabeled 12 cc (cubic centimeter) syringe, on top of the anesthesia cart, with 6 cc of a clear substance in the syringe.

Interview on February 4, 2013, at 2:30 p.m., in the OR #2, with the nurse manager, confirmed the surgical procedures were completed for the day and the room was clean and ready for use. Further interview confimed the syringe was not labeled and contained 6cc of a clear substance, the syringe was unsecured on the anesthesia cart in the OR #2 and was not properly discarded. Further interview with the nurse manager revealed "...anesthesia uses the cart and...do not know what is in the syringe..."

Observation on February 5, 2013, at 9:20 a.m., in the Nuclear Medicine Room, revealed the first drawer of the cabinet contained one 10 cc Heparin flush, (Heparin 100 units/ml) (milliters) syringe, with two cc's of the solution in the syringe.

Interview on February 5, 2013, at 9:20 a.m., in the Nuclear Medicine (NM) Room, with the nuclear medicine technician, revealed "...used it today and did not throw it away..." Further interview with the nuclear medicine technician confirmed the syringe had been used for a patient in the NM room today and the syringe was not secured and was not properly discarded.

Based on observation and interview, the facility failed to ensure proper storage of resident nourishments, in one of one refrigerators observed.

The findings included:

During the tour of the facility on February 5, 2013, at 10:00 a.m., on the medical -surgical unit revealed the patient nourishment refrigerator in the medication storage room contained one opened undated and unlabeled ? pint carton of whole milk and seven 8 ounce containers of Jell-O, with expiration dates of January 25, 2013.

Interview with the Assistant Director of Nursing, on February 5, 2013, at 10:04a.m., in the medical-surgical storage room, confirmed the opened container of milk was opened and the seven containers of Jell-O were expired. Further interview revealed opened containers of food and expired nourishment supplies are not to be stored in the resident nourishment refrigerator.

Based on medical record review and interview, the facility failed to update an admission history and physical for one (#30) of five patients reviewed on the medical surgical unit.

The findings included:

Medical record review revealed patient #30 was admitted to the facility on January 31, 2013, with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD).

Medical record review revealed the patient was admitted from the Emergency Department (ED) and a History and Physical (H&P) was performed and documented by the Emergency Department physician on January 31, 2013, at 7:56 p.m. Further review revealed the admitting physician had not updated or performed an admission H&P on the patient since the patient was admitted to the facility.

Medical record review of the Physician's Progress Note, dated February 3, 2013, with no time, revealed "...patient states some better...still weak less nausea...scattered wheezes...a/d (admitting diagnoses) COPD exac (exacerbation), pneumonia, low albumin..."

Review of the facility policy History and Physical Examinations, dated March, 2012, revealed "...an updated examination of the patient, including any changes in the patient's condition, must be completed and documented within 24 hours of admission or registration...the updated examination of the patient, including any changes in the patient's condition, must be completed and documented by a physician..."

Interview on February 5, 2013, at 10:15 a.m., with the Nurse Manager (NM) of the Medical Surgical Unit, in the NM office, confirmed an updated H&P was not done within 24 hours of admission by the physician.