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.

ADVENTHEALTH ORLANDO 601 E ROLLINS ST ORLANDO, FL 32803 April 19, 2011
VIOLATION: NURSING CARE PLAN Tag No: A0396
Based on interview and record review, the facility failed to ensure keeping the care plan current in the form performing prescribed wound care and dressing changes form 1 of 6 sampled patients (#1).

Findings:

A review of the medical record of patient #1 was performed. Physician orders of 11/03/10 read, "Wound care to bil (bilateral) buttocks. Cleanse with normal saline. Apply Xenaderm to open area & surrounding intact red & purple discoloration. Cover with Adaptic. Repeat TID (three times a day)."

Regarding these orders, nursing documentation revealed that there was only one clearly designated episode of wound care and a dressing change on 11/10/10 (orders were for three a day). This took place at 8 AM. A wound photo was also taken at 2 AM, which could have only been performed with a removal of a wound dressing. Excluding this six hour time window (2-8 AM), there were no episodes of wound care or dressing changes during the remaining eighteen hours. In addition, there was no evidence of the performance of any of the three required wound care sessions and dressing changes on 11/15/10.

The findings were confirmed in an interview with the Assistant Director of Risk Management on 4/19/11 at approximately 6 PM.