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Based on medical record review, policy review, and staff interview it was determined the hospital failed to provide nursing care of the patient receiving a blood transfusion in accordance with hospital policy for five of ten (Patient #'s 3, 4, 7, 8 and 10) patients reviewed.

Findings include:

A review of nursing policy,"Transfusion of Blood and Blood Product", was completed on 04/17/13. The policy directed the registered nurse responsible for the administration of the blood to stay at the patient's bedside for the first 15 minutes after initiating the blood transfusion to watch for a possible transfusion reaction. The policy became effective on 08/01/2012.
Interview with the Director of Nursing and the Vice-President of Nursing on 04/17/13 at 2:00 PM revealed all nursing staff were educated on the policy in August, 2012.

The medical record review for Patient #3 was completed on 04/17/13. This patient received a blood transfusion as ordered by the physician on 04/10/13. The first unit was initiated by the registered nurse at 8:30 AM, the second unit at 12:22 PM. The medical record lacked documentation that the registered nurse remained at the patient's bedside for the first 15 minutes after the initiation of the first or second unit.

The medical record review for Patient #4 was completed on 04/17/13. This patient received a blood transfusion as ordered by the physician on 02/13/13. The first unit was initiated by the registered nurse at 9:05 AM, the second unit at 12:50 PM. The medical record lacked documentation that the registered nurse remained at the patient's bedside for the first 15 minutes after the initiation of the first or second unit.

The medical record review for Patient #7 was completed on 04/17/13. This patient received a blood transfusion as ordered by the physician on 03/11/13. One unit was ordered and initiated by the registered Nurse at 11:25 PM. The medical record lacked documentation that the registered nurse remained at the patient's bedside for the first 15 minutes after the initiation of the unit of blood.

The medical record review for Patient # 8 was completed on 04/17/13. This patient received a blood transfusion as ordered by the physician on 03/26/13. The first unit was initiated by the registered nurse at 5:25 PM, the second unit at 9:30 PM. The medical record lacked documentation that the registered nurse remained at the patient's bedside for the first 15 minutes after the initiation of the first or second unit.

The medical record review for Patient #10 was completed on 04/17/13. This patient received a blood transfusion as ordered by the physician on 04/09/13. The first unit was initiated by the registered nurse at 1:55 AM, the second unit at 6:25 AM. The medical record lacked documentation that the registered nurse remained at the patient's bedside for the first 15 minutes after the initiation of the first or second unit.

These findings were confirmed with Staff A and B on 04/17/13 at 3:00 PM.

This deficiency substantiates Substantial Allegation Number OH00069436.