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MEMORIAL HERMANN HOSPITAL SYSTEM 1635 NORTH LOOP WEST HOUSTON, TX 77008 Oct. 1, 2018
VIOLATION: RN SUPERVISION OF NURSING CARE Tag No: A0395
Based on observation, interview, and record review, nursing staff failed to supervise and evaluate the care of two (2) of four sampled patients ( Patient # 5, # 7).

Patient # 5, # 7 had documented allergies that were not noted on their red allergy armbands.

Findings include:

TX 095

Record review on 10-01-18 of "Patient Report Worksheet" for 6th floor revealed four (4) patients with documented allergies.

Patient # 7:

Had documented allergies to "cefepime, codeine, and vancomycin".

Observation on 10-01-18 at 11 a.m. revealed Patient # 7's red allergy band had only "codeine" listed and not cefepime and vancomycin.

Interview at time of observation with Registered Nurse (RN) # 12, she confirmed in the electronic record, Patient # 7 just had the allergies to cefepime and vancomycin recorded last week on 09-26-18. She said although recent, these allergies should have been listed on the red allergy band.

Patient # 5:

Had a documented allergy to "chlorhexidine topical."

Observation on 10-01-18 at 11:10 a.m. revealed Patient # 5's red allergy armband did not have chlorhexidine listed as an allergy.

Interview at time of observation with RN Manager # 5, he stated this allergy should be noted on the red allergy band.

Record review of facility policy titled " Allergy Identification and Follow-Up Procedure", dated 06-27-16, read: "...General...allergy information will be elicited and documented as early in the admission process as possible, by the registered nurse who assesses the patient., Allergy alerts will be updated promptly whenever additional allergy information is obtained... Responsible Party: RN...Procedures: 1. allergies will be entered into the electronic medical record. 2, An allergy alert sticker will be placed on the front of the patient's chart with all allergies listed. 3. A RED allergy alert armband will be applied adjacent to the ID armband on all patients. If the patient has no drug allergies "NKDA: will be written on the band. All allergies will be handwritten on the allergy alert band. In the case of an exceptionally long list of allergies "multiple allergies--see patient record" may be written on the band instead of the specific allergies..."