Failure to Adhere to Fluid Restriction Orders for Dialysis Resident
Penalty
Summary
The facility failed to adhere to the physician's fluid restriction orders for a resident undergoing dialysis, leading to a deficiency in care. The resident, who has diagnoses of Type 2 Diabetes, Severe Chronic Kidney Disease, and Anemia, was prescribed a fluid restriction of 1000 milliliters per day, with specific allocations for dietary and nursing. However, observations revealed that the resident was provided with 16 ounces of coffee during breakfast on two separate occasions, exceeding the prescribed 6 ounces. This discrepancy was noted despite the meal ticket clearly indicating the fluid restriction and specific fluid amounts allowed. Interviews with the resident and the kitchen manager highlighted a lack of compliance with the fluid restriction orders. The resident, who is cognitively intact, mentioned being aware of her fluid restrictions but believed she was allowed more than prescribed. The kitchen manager admitted to providing two cups of coffee to honor the resident's preferences, despite the meal ticket instructions. The care plan indicated that the resident was non-compliant with dietary restrictions and had been educated on the importance of adhering to fluid restrictions, yet the facility failed to ensure compliance, resulting in the deficiency.