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.

TOUCHETTE REGIONAL HOSPITAL INC 5900 BOND AVENUE CENTREVILLE, IL 62207 July 1, 2013
VIOLATION: RN SUPERVISION OF NURSING CARE Tag No: A0395
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on a review of Hospital policy, record review and staff interview it was determined in 1 of 1 (Pt. #1) medical records reviewed, the Hospital failed to ensure resuscitative management policies were followed to provide prompt response and actions to changes noted in patient's physical condition.
Findings include:

1. The Hospital policy revision date of 8/12 titled, "Resuscitative Management (formerly Code Blue and Express Team) was reviewed on 7/1/13. The policy indicated under "Resuscitative Management: Express Team Procedure: The Express Team's purpose is to enhance patient outcomes by providing early and rapid interventions...to the deteriorating patient...without cardio pulmonary arrest."

2. The medical record of Pt. #1 was reviewed on 7/1/13. Documentation indicated Pt. #1 was admitted on [DATE] through the ED with diagnoses of Psychosis NOS and Right Foot Pain. Documentation indicated on 5/27/13 Pt. #1 was in the dining room in a w/c. Pt. #1 stated he was not feeling well and slid out of w/c onto the floor. Pt. #1 was asked to get back into w/c, but was unable to without assistance of 2 staff members. Documentation indicated Pt #1 was perspiring and a nurse attempted to take blood pressure but was unable to hear. Documentation indicated the nurse called for the Charge Nurse and the ED was called to transport Pt. #1. ED physician stated he would come to the unit. Documentation indicated the ED physician called a "Code Blue" after arriving to the unit. There was no documentation in the medical record to indicate an "Express Team" was called to the unit to assess Pt. #1.

3. During an interview with the ED physician on 7/1/13 at 1:55 PM, the ED physician confirmed a Code was called after arrival on the Psychiatric unit. During an interview with the VP on 7/1/13 at 2:15 PM, the VP indicated the Express Team was not called by the staff but a Code Blue was called by the ED physician after arrival to the Psychiatric Unit.