Bringing transparency to federal inspections
Tag No.: C0225
Based on observation it was determined the hospital failed to maintain a sanitary environment for patients, visitors, and staff. Findings include:
1. During tour of the hospital kitchen area on 02/08/10 at approximately 2:30 p.m. the following observation was made:
a. The horizontal surfaces of the range hood, the wall surface, light fixtures, and air supply vents above the range hood and stove cooking area had an accumulation of dust and grease.
Tag No.: C0278
Based on observations and staff interview, the hospital failed to adequately maintain solid, cleanable work surfaces in the microbiology department. This has the potential to negatively impact all patient care by possibly cross-contaminating laboratory tests due to not being able to properly clean the surfaces in the microbiology department. Findings include:
1. On February 8, 2010 at 1500, during an inspection and observations of the microbiology department of the laboratory, the countertop of the hood-area was noted to be cracked and with multiple areas of the laminate chipped-off, exposing the porous wooden interior.
2. During the same inspection and observations of the microbiology department, the countertop of the sink was noted to have areas of laminate chipped-off as well as an entire corner broken-off, exposing the porous wooden interior.
3. The laboratory director was present during the observations and agreed with the findings.
Tag No.: C0297
Based on document review, medical record review and staff interview, the hospital failed to ensure the nursing staff administers medications as ordered by the physician in one (1) of three (3) open acute care medical records (Patient #16) reviewed. This has the potential to negatively impact all patient care by patients not receiving potential life-saving medications. Findings include:
1. Minnie Hamilton Health System policy and procedure, Medication Administration, last reviewed 8/2009, states in part "...1. Gather equipment
e. Medication as ordered by physician..."
2. Review of the current medication administration record for Patient #16 revealed the patient was scheduled Levaquin 250mg (milligrams), Colace 100mg, Lasix 20mg, Prilosec 20mg, and Aldactone 25mg at 0900 on both 2/9/10 and 2/10/10. On both days, however, the nurse documented the medications were all held (not given) with the reasoning as the patient being NPO (nothing by mouth). However, further review of the record revealed no documented evidence of physician orders for NPO status or for the medications to be held.
3. In the morning of 2/10/10, during an interview with the Licensed Practical Nurse (LPN), the medical record was reviewed. The LPN stated the patient was NPO for a procedure both mornings but agreed there was no written order for NPO status or for the medications to be held.