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Tag No.: A0168
Based on record review and staff interview, it has been determined that the hospital failed to ensure the use of a restraint has been applied in accordance with the order of a physician or other licensed independent practitioner for 1 of 1 relevant sample patients ID # 10.
Findings are as follows:
Record review reveals patient ID# 10 was restrained on 8/24/2015 at approximately 8:27 PM secondary to attempting to interfering with medical interventions (attempting to remove intubation tube). The restraint was renewed on 8/25/2015 at 7:36 PM. The record reveals the intubation tube was removed on 8/27/2015 between 9 AM and 10 AM. The restraints were removed at this time.
During a review of the patient's electronic medical record with the patient's registered nurse (Staff A) on 8/27/2015 at approximately 11:10 AM, she was unable to provide evidence of an order from a physician or other licensed independent practitioner.
Tag No.: A0171
Based on record review and staff interview, it has been determined that the hospital failed to ensure that the physician's order for a restraint renewal not exceed 24 hours for 1 of 1 relevant sample patients ID# 10.
Findings are as follows:
Record review reveals patient ID# 10 was restrained on 8/24/2015 at approximately 8:36 PM and renewed on 8/25/2015 at 7:36 PM. The record reveals the intubation tube was removed on 8/27/2015 between 9 AM and 10 AM. The restraints were removed at this time.
During a review of the patient's electronic medical record with the patient's registered nurse (Staff A) on 8/27/2015 at approximately 11:10 AM, she was unable to provide evidence that the restraints were reordered within a 24 hours time frame.