HospitalInspections.org

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Based on interview, record review and review of hospital policies and procedures and medical staff bylaws, the hospital failed to comply with all requirements of 489.24.

Failure to ensure patients receive a comprehensive medical screening examination by a qualified medical professional may result in patient physical harm including death.

Refer to citation and example at:

A 2406 (489.24 (a) Medical Screening Exam By Qualified Medical Personnel- The hospital failed to have language in by-laws, approved by the Governing Body that specified which medically qualified personnel had been determined qualified to conduct emergency medical screening exams (MSEs).
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Based on interview, review of hospital policy and procedures, record review and staff interview, the hospital failed to ensure that individuals entering the building seeking medical assistance were initially screened by qualified staff, and failed to specify in hospital regulations or by-laws which medically qualified personnel had been determined qualified to conduct emergency medical screening exams (MSEs).

Failure to provide screening by a qualified staff member as defined by the Hospital's Governing Body, risked patient health and safety.

Findings included:

1. Review of the hospital's Medical Staff By-laws approved by the Governing Body in 2016 showed that every patient who presents to Newport Community Hospital Emergency Department requesting an evaluation for medical condition will receive an appropriate medical screening exam, (MSE), performed by the Emergency Room Provider.

2. Review of the hospital's policy titled, "Obstetrical Patient in the Emergency Department- Walk In," number 1107, dated 02/19 showed that any obstetrical patient at 20 weeks gestation or more with complaints which are related to pregnancy will receive initial screening in the Obstetrical (OB) Department. Fetal well-being and the labor status will be assessed with the assistance of fetal monitoring. Following the nursing assessment, the nurse will contact the patient's primary care practitioner. The patient will then be provided care as directed by the physician.

3. Medical records reviewed with the Chief Nursing Officer, (Staff #1302), and the Director of Quality, (Staff #1303), showed that patients were discharged home without being seen by an Emergency Department Provider or the patient's physician for 5 of 5 charts reviewed. (Patients #21, 22, 23, 24 and 25).

4. During an interview on 05/04/21 at 9:40 AM with the OB Coordinator, (Staff #1307), stated that patients greater than 20 weeks gestation are sent to OB Department for triage. After the RN assessment, the OB provider is called. If labor is imminent, the OB provider is called to come in. If not, the OB provider gives orders for care or discharge.

5. During an interview on 05/04/21 at 1:00 PM with the Medical Staff Credentialing Coordinator, (Staff #1308), stated there is no section of the Medical Staff By-Laws that authorize anyone other than Emergency Department providers to perform Medical Screening Exams (MSEs).