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.
|CLARK MEMORIAL HOSPITAL||1220 MISSOURI AVE JEFFERSONVILLE, IN 47130||Oct. 4, 2011|
|VIOLATION: RN SUPERVISION OF NURSING CARE||Tag No: A0395|
|**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on document review and interview, the facility failed to ensure a registered nurse evaluated the care provided to 1 of 5 patients (patient #1).
1. Review of patient #1 medical record indicated the following:
(A) An order was written on 7/5/11 for 4x4 border gauze to ulcer on right leg every other day. The medical record lacked documentation that the treatment was carried out per order. Per record review, the gauze was changed only on 7/6/11 and 7/12/11.
(B) The medical record indicated that the patient had only one (1) bowel movement during the hospitalization (BM on 7/6/11). The record lacked documentation that the lack of a bowel movement was reported to the physician or was addressed during the stay. The patient was discharged on [DATE].
2. Staff member #2 indicated the following in interview at 2:45 p.m.:
(A) He/she verified that the medical record lacked documentation that the physician orders for dressing to the right leg were followed and that the lack of a bowel movement was reported or addressed.