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.
|SAINT FRANCIS HOSPITAL MUSKOGEE||300 ROCKEFELLER DRIVE MUSKOGEE, OK 74401||Aug. 13, 2019|
|VIOLATION: RN SUPERVISION OF NURSING CARE||Tag No: A0395|
|**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based upon record review and interview, the hospital failed to ensure the Registered Nurse conducted an evaluation on admission and throughout each patient's hospitalization . This was evidenced by the failure to document an accurate initial and on-going nursing assessments for one (#1) of seven medical records reviewed.
Review of the medical record for patient #1 revealed the patient was admitted on [DATE] for the chief complaint of Pneumonia, Congested Health Failure, and Acute Respiratory Failure. The patient also had a history of [DIAGNOSES REDACTED]and was on the blood thinner medication Warfarin. Review of the initial admission nursing assessment dated [DATE] and the 12 hour nursing assessments (06/21/19-07/09/19) revealed the Registered Nurse documented the patient had "multiple large purple" bruises; however, no location or size of the bruises were identified.
Interview on 08/12/19 at 10:35 a.m. with Staff E revealed patient #1 had bruising to the abdomen and arm and agreed the location and size of the bruises was not documented.