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SPRING HARBOR HOSPITAL 123 ANDOVER ROAD WESTBROOK, ME Oct. 20, 2016
VIOLATION: PATIENT RIGHTS: FREE FROM ABUSE/HARASSMENT Tag No: A0145
Based on interviews and record review, the facility failed to ensure that a patient was free from physical abuse. On October 11, 2016, an altercation occurred between a patient and a Registered Nurse (RN). The registered nurse (RN #1) kicked a patient in the face which resulted in the patient requiring medical attention for physical injuries.
Findings:

On October 11, 2016 at approximately 8:00 PM, an altercation occurred in which a patient was verbalizing to an RN (RN #1) to stop looking at him/her. The patient continued to escalate verbally, reached over the nurses' station and made physical contact with RN #1. A witness to the incident reported that RN #1 jumped to the top of a desk, located approximately four feet above the floor level, and intentionally kicked the patient in the face resulting in physical harm to the patient. The patient required medical treatment and was sent to the nearest emergency department.

On October 20, 2016 at approximately 12:00 PM, a witness to the incident, a psychiatric technician and "Safe Care" educator, was interviewed. The witness stated," The RN (RN #1) said to the patient 'you better watch it. If you keep it up, I'll show you what will happen.' He ( RN #1) then jumped up onto the desk ... and then jumped feet first and kicked the patient in the face."

On October 20, 2016 at 3:34 PM, a staff RN (RN #2) was interviewed. RN #2 stated that after the incident RN #1 entered her unit and admitted to assaulting the patient. She stated, "He (RN#1) described what happened with sort of bravado. He said, 'No one's gonna hit me, so I kicked (the patient) in the face."

On October 20, 2016 at approximately 1:45PM, the patient was interviewed. He/she stated, "He got up on the counter and jumped at me like a WWF wrestler; he kicked me in the face; I grabbed his leg and he fell to the floor on his back. I've had a headache ever since."

On October 20, 2016, at approximately 2:45 PM, the Clinical Support Coordinator was interviewed, she reported, "I saw him (RN #1) jump up onto the counter ... He just jumped up ..."

A review of the patient's medical record revealed the following nursing notes:
1. 10/11/16 a11:27 PM - Patient threatened staff and attempted to jump over nurse's station and threw a punch at the male staff knocking off his glasses and injuring his nose. Writer called a code and next saw staff and patient on the other side of the nurse's station.
2. 10/13/16 at 11:06 PM - ... after the physical altercation, patient had a small laceration on left eye and redness underneath on cheek bone.
3. Emergency department visit note of October 12, 2016 revealed that the patient sustained an injury due to an altercation: Forehead contusion and cervical strain

On October 20, 2016 at approximately 2:25 PM, the Vice President of Operations confirmed during an interview with the surveyors that her investigation confirmed the physical contact between the patient and RN #1 occurred and that RN #1 was terminated from the hospital.