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Based on observations, hospital policy review, medical record reviews and interview, the nursing staff failed to ensure the patients had access to the call bell and telephone for 2 of 2 patients observed sitting in a bedside chair and failed to ensure an admission assessment was completed for an internal patient transfer per the hospital policy for 1 of 4 (Patient #1) sampled record reviewed.

Findings include:

1. During tour of the medical-surgical unit on 11/15/2023 between 0950 and 0955, two med-surg patients were observed sitting up in a chair on the left side of the bed. The call bell for the first patient was observed lying on the bedside table which was located on the right side of the bed, and out of the patient's reach. The call bell for the second patient was observed lying on the patient's bed and out of the patient's reach.

Interview on 11/15/2023 at 0955 with NM #1 revealed the nursing staff were expected to ensure the patient's call bell was available for patient use at all times. The nursing staff should educate the patients on the use of the call bell. Interview confirmed the call bells were not available for patient use.

2. Review on 11/15/2023 of the hospital policy "Assessment/Reassessment" effective date October 2023 revealed " ...Policy ...C ... 1. Patients will receive a full/complete assessment by an RN: ... c. When patient is transferred from one level of care to another level of care. ... Addendum A - Assessment Parameters Inpatient Units - Nursing ... Medical Units ...Initiation of Admission Assessment ...Within one hour of arrival. ..."

Closed medical record review on 11/14/2023 for Patient #1 revealed a 90-year-old male that presented to the Emergency Department (ED) via ambulance on 07/06/2022 at 1314 with a chief complaint of extremity weakness for three (3) days with fevers since 07/05/2022. Patient #1 complained of generalized weakness and COVID-19. The Patient was admitted to the Progressive Care unit (PCU) on 07/06/2022 at 2111. Patient #1 was transferred from the PCU to the medical-surgical unit on 07/07/2022 at 1538. Review of the nursing notes revealed an assessment was completed at 1700 (1 ½ hours after transfer to another level of care).

Interview on 11/16/2023 at 1305 with RN (Registered Nurse) #1 revealed that patients being transferred to another level of care should be treated as a new admission, and the admission assessment should have been completed within one (1) hour of arrival.

NC00190994