The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.
CHI-ST VINCENT INFIRMARY | TWO ST VINCENT CIRCLE LITTLE ROCK, AR 72205 | Oct. 2, 2014 |
VIOLATION: PATIENT RIGHTS: RESTRAINT OR SECLUSION | Tag No: A0160 | |
Based on review of clinical records and interview it was determined the Facility failed to assure chemical restraints were not ordered PRN (as needed) for seven (#1-#7) of 7 patients on 8E (East)/8W (West), the Psychiatric Unit. Failure to assure chemical restraints were not ordered PRN did not assure patients' behavior was managed by physician order and not at the discretion or convenience of a nurse. This failed practice was likely to affect all patients admitted to the Facility. Findings follow: A. Review of Order Information for chlorpromazine (Thorazine) for Patients #1 and #2 revealed chlorpromazine 50 mg (milligram) IM (intramuscular) PRN agitation, threatening self or others or acute psychotic symptoms was ordered. B. Review of Order Information for haloperidol (Haldol) for Patients #3-#7 revealed haloperidol (Haldol) 5 mg IM PRN agitation, threatening self or others or acute psychotic symptoms was ordered. C. Findings were confirmed during interview with the Registered Nurse #1 on 10/02/14 at 1015. |
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VIOLATION: STAFFING AND DELIVERY OF CARE | Tag No: A0392 | |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of clinical records and interview, it was determined the Facility failed to have a policy for bathing patients and nursing staff failed to document baths for four (#9, #10, #13 and #18) of 13 (#8-#20) patients admitted to 4NW (Northwest), a Medical Surgical Unit. The failed practices did not assure personal hygiene was offered or conducted and was likely to cause skin breakdown, infections, decreased dignity and self-esteem. Those failed practices were likely to affect all patients admitted to the Facility. Findings follow: A. During interview with the Regulatory Officer on 10/02/14 at 1230 when asked for a policy for bathing schedules and documentation, she stated there was no policy. B. Review of Activities for Daily Living, Hygiene for Patient #9, admitted [DATE] revealed no baths were documented from 09/22/14 through 09/25/14 or that Patient #9 refused a bath. C. Review of Activities for Daily Living, Hygiene for Patient #10, admitted [DATE] revealed no baths were documented from 09/28/14 through 10/01/14 or that Patient #10 refused a bath. D. Review of Activities for Daily Living, Hygiene for Patient #13 admitted [DATE] revealed no baths were documented from 09/20/14 through 09/24/14, 09/26/14 and 09/27/14, 09/29/14 and 09/30/14 or that Patient #13 refused a bath. E. Review of Activities for Daily Living, Hygiene for Patient #18, admitted [DATE] revealed no baths were documented from 08/07/14 through 08/09/14 or that Patient #18 refused a bath. F. During interview with Registered Nurse #2 on 10/02/14 at 1015, he confirmed baths/showers were poorly documented in the clinical records under review. G. Findings were confirmed with Registered Nurse #2 on 10/02/14 at 1050. |
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VIOLATION: DIETS | Tag No: A0630 | |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of clinical records and interview, it was determined staff failed to document percentages of meals eaten in six (#9, #10, #12, #13, #15, and #17) of 13 (#8-#20) records for patients admitted to 4 NW (Northwest), a Medical Surgical Unit. Failure to document percentages of meals eaten prevented staff from assuring the nutritional needs of patients were being met and was likely to affect all patients admitted to the Facility. Findings follow: A. Review of Activities for Daily Living, Nutrition for Patient #9, admitted [DATE] revealed no documentation of percent of meals eaten from 09/27/14 through 10/01/14. B. Review of Activities for Daily Living, Nutrition for Patient #10, admitted [DATE] revealed no documentation of the percent of dinner eaten on 10/01/14 and no documentation of the percent of breakfast eaten on 10/02/14. C. Review of Activities for Daily Living, Nutrition for Patient #12, admitted [DATE] revealed no documentation of the percent of meals eaten from 09/26/14 through 10/02/14 with the exception of breakfast on 10/02/14. D. Review of Activities for Daily Living, Nutrition for Patient #13, admitted [DATE] revealed no documentation of the percent of meals eaten from 09/20/14 through 10/02/14 with the exception of supplement on 09/23/14, breakfast and lunch on 09/24/14, breakfast and lunch 09/25/14 and breakfast 10/02/14. E. Review of Activities for Daily Living, Nutrition for Patient #15 admitted [DATE] revealed no documentation of the percent of meals eaten from 09/28/14 through 10/02/14 with the exception of breakfast on 10/02/14. F. Review of Activities for Daily Living, Nutrition for Patient #17 admitted [DATE] revealed no documentation of the percent of meals eaten from 08/06/14 through 08/08/14 with the exception of breakfast on 08/07/14. G. Findings were confirmed with Registered Nurse #2 on 10/02/14 at 1050. |