Failure to Develop Person-Centered Care Plan for Wound Management
Penalty
Summary
The facility failed to develop a person-centered care plan for a resident who consistently refused wound vacuum therapy on dialysis days. Resident 16, admitted with diagnoses including acquired absence of left toes and end-stage renal disease requiring dialysis, had a physician order for continuous wound vac therapy on the left medial foot. The order specified settings of 120 mmHg pressure intensity, with adjustments for pain tolerance. However, the resident refused the wound vac on days they went out for dialysis, which occurred every Tuesday, Thursday, and Saturday. The care plan, last updated in October 2024, did not address these refusals or provide interventions for wound management when the resident left the facility. This deficiency was confirmed by the Director of Nursing during an interview.
Plan Of Correction
1. Resident #16 has discharged from the facility. 2. An audit will be completed by DON, or designee, of all in-house residents utilizing wound vacuums to ensure refusals are addressed in the care plan along with interventions on how to treat the wound when off. 3. Education will be provided to all licensed nursing staff to ensure residents refusing their wound vacuum have a person-centered care plan that includes management and refusals to meet the resident's specific needs. 4. The DON, or designee, will complete audits on residents utilizing wound vacuums to ensure refusals are addressed in the care plan along with interventions on how to treat the wound when off. Results of these audits will be reviewed with the QAA committee x 3 months then re-evaluated.