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BAPTIST HEALTH MEDICAL CENTER NORTH LITTLE ROCK 3333 SPRINGHILL DRIVE NORTH LITTLE ROCK, AR 72117 April 11, 2018
VIOLATION: ORGANIZATION OF NURSING SERVICES Tag No: A0386
Based on clinical record review and interview it was determined the facility failed to ensure organization of nursing services in that baths were not documented every other day as per facility expectations for five (#1-#4 and #10) of 20 (#1 - #20) Patients. The failed practice did not ensure patients' skin integrity was maintained, and did not ensure patients were assessed as to their level of assistance needed with that ADL (Activity of Daily Living). The failed practice had the likelihood to affect any patient in the facility. Findings follow.

A. During an interview on 04/1/18 at 12:18 PM, the Rehab (Rehabilitation) Nurse Manager stated there was no specific policy as to how often patients were to be bathed, however, the expectation was at least every other day.
B. Review of an inservice conducted on 03/30/18 showed: All patients are to be bathed every other day. Odd rooms are to be bathed on day shift. Even rooms are to be bathed on night shift. If a patient requests to be bathed, they are to receive a bath/shower regardless of the schedule. Patients cannot refuse a bath without RN (Registered Nurse) approval.
C. Review of the clinical record of Patient #1 showed an admission of 03/16/18 - 03/26/18. There was no evidence a bath/shower was given from 03/16/18 through 03/22/18. The findings were confirmed by the Rehab Nurse Manager on 04/10/18 at 2:00 PM.
D. Review of the clinical record of Patient #2 showed an admission of 03/16/18 - 03/27/18. There was no evidence a bath/shower was given from 03/16/18 through 03/22/18. The findings were confirmed by the Rehab Nurse Manager on 04/10/18 at 2:15 PM.
E. Review of the clinical record of Patient #3 showed an admission of 03/22/18 - 04/02/18. There was no evidence a bath/shower was given on 03/25/18 or 03/26/18. The findings were confirmed by the Rehab Nurse Manager on 04/10/18 at 12:50 PM.
F. Review of the clinical record of Patient #4 showed an admission of 03/04/18 - 03/16/18. There was no evidence a bath/shower was given on 03/08/18, or from 03/14/18 through 03/16/18. The findings were confirmed by the Rehab Nurse Manager on 04/11/18 at 12:18 PM
G. Review of the clinical record of Patient #10 showed an admission of 03/29/18 - 04/10/18.
There was no evidence a bath/shower was given from 04/05/18 through 04/07/18. The findings were confirmed by the Rehab Nurse Manager on 04/11/18 at 11:17 AM.