Failure to Provide Appropriate Respiratory Care
Penalty
Summary
The facility failed to provide appropriate respiratory care and services for a resident who required oxygen therapy and BiPAP for sleep apnea. The clinical record for the resident indicated a physician's order for oxygen to be administered at 5 liters per minute (LPM) via nasal cannula continuously during the day and evening, and 6 to 7 LPM at bedtime with BiPAP. However, observations revealed that the resident's oxygen concentrator was set at 9 LPM without humidification, which deviated from the prescribed order. Additionally, the resident's BiPAP mask was found unbagged and improperly stored, lying on the floor behind the oxygen concentrator and on the bedside stand during different observations. This improper handling and storage of respiratory equipment could increase the risk of infection, as noted by the American Association for Respiratory Care, which emphasizes the importance of proper cleaning and storage of nebulizer equipment to reduce infection risk. The deficiency was discussed with the Director of Nursing during the survey.
Plan Of Correction
Cited: Resident 43's oxygen order was clarified. Resident 43's Bipap mask was placed in an appropriate bag. • Like: Facility-wide sweep was completed to ensure residents who have active oxygen orders are correctly being followed. Facility-wide sweep also completed to ensure appropriate respiratory supplies are stored in bags appropriately. • Education: DON/designee will educate nursing staff on ensuring oxygen orders are followed and respiratory equipment is stored appropriately. • Audits: DON/designee will audit 5 residents per week x 4 weeks then monthly x 2 months to ensure oxygen orders are appropriately followed and that respiratory equipment is stored appropriately. Results will be taken through QAPI.