Deficiency in Person-Centered Dialysis Care
Penalty
Summary
The facility failed to provide person-centered care for a resident who required hemodialysis, specifically in the management of their arteriovenous (AV) fistula. The resident, who was admitted with end-stage kidney disease and dependent on dialysis, had a right arm AV fistula for dialysis access. Physician orders specified dialysis days and times, as well as instructions for the care of the AV fistula, including checking for bruit and thrill daily and using an emergency kit at the bedside. However, these orders did not detail specific care for the AV fistula. The resident's care plan included general interventions related to dialysis access but lacked individualized interventions for the monitoring, care, maintenance, or emergency management of the AV fistula site. During an interview, the Director of Nursing confirmed the absence of a care plan that included emergency measures or planned care specific to the AV fistula for this resident. This oversight was identified as a deficiency in providing appropriate dialysis care and services.
Plan Of Correction
1. R-60's Dialysis care plan was updated. 2. Care plans for other residents with Dialysis have been reviewed and addressed accordingly. 3. Quarterly review of care plans for Dialysis residents will occur to ensure individualized care plans. 4. Monthly audit of Dialysis resident's care plans to ensure accuracy for three months. Audits will be submitted to the QA Committee for three months.