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Based on interviews and clinical record review, it was determined a Registered Nurse failed to supervise the nursing care of seven (#1, #2, #3, #7, #8, #12 and #13) of seven (#1, #2, #3, #7, #8, #12 and #13) patients in that vital signs were not obtained every four hours per physician's orders and one (Patient #4) of one (Patient #4) Patient's weight was not obtained every two days per physician's orders. Failure to provide care per physician's order did not ensure patients received the highest quality of care to facilitate patient progress and be discharged. The failed practice affected Patients #1-#4, #7-#8, and #12-#13. Findings follow:

A. Review of the clinical record of Patient #1 revealed physician's orders dated 08/13/15 to obtain vital signs every four hours. Review of the clinical record of Patient #1 revealed vital signs were not documented every four hours from the admission date of 08/13/15 through the discharge date of 08/17/16.
B. Review of the clinical record of Patient #2 revealed physician's orders dated 08/03/15 to obtain vital signs every four hours. Review of the clinical record of Patient #2 revealed vital signs were not documented every four hours from the admission date of 08/03/15 through the discharge date of 08/10/15.
C. Review of the clinical record of Patient #3 revealed physician's orders dated 09/25/16 to obtain vital signs every four hours. Review of the clinical record of Patient #3 revealed vital signs were not documented every four hours from the admission date of 09/25/15 through the discharge date of 10/06/15.
D. Review of the clinical record of Patient #7 revealed physician's orders dated 09/15/16 to obtain vital signs every four hours. Review of the clinical record of Patient #7 revealed vital signs were not documented every four hours from the admission date of 09/15/16 through 09/22/16.
E. Review of the clinical record of Patient #8 revealed physician's orders to obtain vital signs every four hours. Review of the clinical record of Patient #8 revealed vital signs were not documented every four hours from the admission date of 09/06/16 through 09/22/16.
F. Review of the clinical record of Patient #8 revealed physician's orders dated 09/06/16 to obtain vital signs every four hours. Review of the clinical record of Patient #12 revealed vital signs were not documented every four hours from the admission date of 09/06/16 through 09/22/16.
G. Review of the clinical record of Patient #12 revealed physician's orders dated 09/06/16 to obtain vital signs every four hours. Review of the clinical record of Patient #13 revealed vital signs were not documented every four hours from the admission date of 09/17/16 through 09/22/16.
H. Review of the clinical record of Patient #4 revealed physician's orders dated 09/01/15 to obtain a patient weight every two days. Review of the Admission Database completed by RN #4 at 1155 on 09/01/15 revealed Patient #4's admission weight was 214.5. Review of the clinical record revealed Patient #4 was weighed weekly on 09/08/15, 09/15/15 and 09/22/15.
I. During an interview with the Director of Quality Management from 1230 through 1250 on 09/22/16 he confirmed the findings in A, B, C, D, E, F, G and H.