HospitalInspections.org

Based on interview and document review the critical access hospital (CAH) failed to ensure informed consents for surgery were signed, timed, and dated for 1 of 5 (P1) surgical records reviewed.

Findings include:

P1's Consent for Surgery and/or Invasive Procedures was signed and dated by P1 and registered nurse (RN)-M. However, the surgeon did not sign, date, or time the consent.

During an interview on 6/13/18, at 3:30 p.m. with RN-A she stated the consent form should have been signed and dated by the surgeon/provider. RN-A stated the pre-op nurse and the surgical nurse should have made sure the consent was signed by the surgeon/provider. RN-A stated the surgeon/provider did not sign P1's Consent for Surgery and/or Invasive Procedures.

During an interview on 6/14/18, at 11:28 a.m. with RN-B she stated the pre-op nurse obtained the consent from the patient. RN-B stated when the surgical nurse takes the patient to the operating room they would check to see the consent is signed by the patient, the witness and surgeon/provider. RN-B stated it was a standard of care to have the consent signed by the surgeon/provider.

During an interview on 6/14/18, at 11:34 a.m. with RN-C she stated the surgeon/provider was expected to sign the Consent for Surgery and/or Invasive Procedures from. RN-C stated the pre-op nurse starts the consent and should get the surgeon/provider to sign the consent after the area of surgery is marked by the surgeon/provider. RN-C stated the circulating nurse (manages all the necessary care inside the surgery room) could have the surgeon/provider sign the Consent for Surgery and/or Invasive Procedures too.

A CAH policy Informed Consent/Informed Decision Making dated 4/7/15, indicated the purpose was to ensure all patients have received and understood consent/informed decision making. In addition, it is the responsibility of every Practitioner on the Medical Staff to obtain appropriate informed consent from their clients before performing procedures, tests and treatments for which a clients' informed consent is required.

Based on interview and document review the critical access hospital (CAH) failed to develop a emergency plan to ensure adequate water availability in the event of an emergency or disruption of water supply. This has the potential of affecting all patients and services provided at the CAH.

Findings include:

During the kitchen tour on 6/12/18 at 7:30 a.m., the certified dietary manager, (CDM) provide a document from the Long Prairie Volunteer Fire Department dated 12/12/17. The document stipulated the following:
"The Long Prairie Fire Department agrees to supply water tankers to CentraCare Hospital and Clinic, CentraCare Long Term Care and CentraCare Meadow Place. This would be in the event these buildings lost water service or the water was contaminated. The water supplied would be non-potable only."

The CAH policy "Water Requirements" last revised 3/2018, had a specific formula for the amount of potable water required in the event of an emergency. The CAH did not have an agreement or a contract with a provider who would agree to provide the amount of potable water delineated in the policy.


In an interview with the Maintenance manager, 6/14/18 at 1:45 p.m., acknowledged that the water agreement was adequate.