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.

JOHN H STROGER JR HOSPITAL 1901 W HARRISON ST CHICAGO, IL 60612 Jan. 15, 2015
VIOLATION: ADMINISTRATION OF DRUGS Tag No: A0405
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


Based on record review and interview it was determined in 1 of 4 (Pt#1) clinical records reviewed for medication administration, the Hospital failed to ensure the nurse administered medication as indicated in the physician's orders.

Findings include:

1. The clinical record for Pt. #1 was reviewed on 1/13/15. Pt#1 was a [AGE] year old female admitted on [DATE] with a diagnosis of acute stroke. On 10/3/14 at 5:24 PM a physician documented "MRI head could not be done due to claustrophobia."

Pt#1's clinical record contained a physician's order dated 10/3/14 at 9:00 PM for Lorazepam 2 milligrams (mg) (anti-anxiety medication) to be administered intravenously "before being taken down for MRI (Magnetic Resonance Imaging) at 10:00 PM." Pt #1 went for an MRI on 10/3/14 at 10:00 PM, however, the clinical record lacked documentation of Lorazepam being administered as ordered, before the procedure.

2. On 1/14/15 at 1:00PM the Attending Physician (MD#1) stated it is unclear if Lorazepam was administered as ordered.
VIOLATION: RN SUPERVISION OF NURSING CARE Tag No: A0395
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


A. Based on document review, observational tour, and interview, it was determined that for 1 of 2 (transport defibrillator) defibrillators on 8 west, the Hospital failed to ensure the defibrillator was checked every shift as required.

Findings include:

1. Hospital policy entitled, "Defibrillation; External, for Life-threatening Arrhythmias," (approval date April 1, 2014) required, "Policy...8. To ensure operability, at the beginning of each shift, defibrillators are checked for proper functioning.."

2. On 1/13/15 at approximately 12:00 PM during an observational tour of the 8 west nursing unit, the 2 unit defibrillators were observed. The transport defibrillator's testing printout was reviewed. The printout failed to include checks every shift as required from 1/6/15 at 10:23 AM to 1/10/15 at 9:12PM (3 days).

3. The Nurse Coordinator II of Medical-Surgical Nursing stated the defibrillator should have been checked every shift.

B. Based on document review and interview, it was determined that for 2 of 2 (Pt# 2 and 3) clinical records reviewed on 8 west for intake and output monitoring, the Hospital failed to ensure all patients' orders were followed as required.

Findings include:

1. The clinical record of Pt #2 was reviewed on 1/13/15. Pt #2 was a [AGE] year old female admitted on [DATE] with a diagnosis of Ascites. Pt #2's clinical record contained a physician's order dated 1/9/15 at 2:58 PM that required chest tube drainage to be measured every 4 hours. Pt #2's intake and output records for 1/9/15 to current lacked documentation of every 4 hour output monitoring from the chest tube as required. Examples include: 1/9/15 from 3:00 PM to 10:00 PM (7 hours); 1/10/15 from 5:00 AM to 2:00 PM (8 hours); 1/11/15 from 6:00 AM to 2:00 PM (8 hours); and 1/12/15 from 2:00 PM to 10:00 PM (8 hours).

2. The clinical record of Pt #3 was reviewed on 1/13/15. Pt #3 was a [AGE] year old female admitted on [DATE] with a diagnosis of anemia. Pt #3's clinical record contained a physician's order dated 1/13/15 at 1:39 AM that required strict I & O (intake and output) every 8 hours. Pt #3's intake and output record for 1/13/15 lacked documentation of Pt #3's I & O for the shift ending at 6:59 AM on 1/13/15.

3. The Nurse Clinician for 8 west stated during an interview on 1/13/15 at approximately 12:45 PM, that the patients' intake and outputs were not documented as ordered.