Failure to Revise Care Plan for Feeding-Related Care
Penalty
Summary
The facility failed to revise the care plan for a resident, identified as R124, specifically concerning Feeding-Related Care. The resident was admitted to the facility with several diagnoses, including Dementia, Severe Protein-Calorie Malnutrition, Adult Failure to Thrive, and Muscle Wasting and Atrophy. These conditions necessitate careful management of nutritional intake and hydration. A physician's order dated November 19, 2024, specified an automatic water flush of 55 ml/hr via PEG tube for 12 hours while enteral feed runs, totaling 660 ml over 24 hours, with an additional flush of 50 ml after each feeding. On December 17, 2024, it was observed that the care plan for Resident R124 had not been updated to reflect these specific hydration orders. This oversight was confirmed during an interview with the charge nurse, identified as employee E19. The failure to update the care plan to include the ordered volume of water flush represents a deficiency in the facility's compliance with the care planning requirements, as outlined in 28 Pa Code 211.11(d) Resident Care Plan.
Plan Of Correction
Resident R124 Care plan has been updated to reflect the goal and interventions with the ordered volume of water flush. DON / Designee to conduct an initial audit of current residents with physician orders for water flushes via tube to ensure care plan reflects volume of water flush. NPE / DON / Designee to re-educate professional nurses regarding updating care plan to reflect volume of water flush. DON / Designee to complete weekly audits X 4 then monthly X 2 for residents with orders for water flushes via tube to ensure care plan reflects volume of water flush. DON/Designee will report the findings of the audits to the QAPI Committee X 3 months.