Failure to Ensure Dignified and Respectful Staff Interaction with Resident
Penalty
Summary
A deficiency was identified when a staff member failed to interact with a resident in a dignified and respectful manner. The resident, who has Down syndrome, unspecified dementia, and a history of severe cognitive impairment, was observed calling out, moaning, and crying in her room. During this time, a housekeeping staff member entered the room, asked what the resident needed, and, upon not receiving a clear response, told the resident, "We're not just gonna sit and cry," instructed her not to call out and to use her call light, and then left the room after one to two minutes. The staff member did not offer any diversionary activities or seek assistance from nursing staff, despite the resident's ongoing distress. The resident later expressed negative feelings about the interaction, indicating that the staff member had spoken to her in this manner before. The staff member admitted to making the statement and acknowledged that it sounded harsh, but justified it as preferable to yelling. The staff member also reported that other staff sometimes used a harsh tone with the resident when she called out frequently, although she could not provide specific details. The resident's care plan included interventions for behavioral issues such as yelling and crying, recommending diversional activities and supportive, nonpharmacologic interventions, none of which were implemented during the observed incident. Facility policy requires staff to interact with residents in a way that maintains and enhances their dignity and self-worth. The staff member's actions did not align with this policy or with the resident's care plan, as the interaction lacked supportive responses and failed to provide recommended diversional activities. The incident was confirmed by both the Director of Nursing and the Nursing Home Administrator as inappropriate and not in accordance with facility expectations for resident interactions.
Plan Of Correction
F550 Resident Rights/Exercise of Rights Resident #9 still resides within the facility. Social Services followed up with resident and has had no emotional or mental effects from the interaction. Housekeeping staff F received 1:1 education. Residents who reside within the facility have the potential to be affected. Inter-viewable residents were queried regarding Resident Rights. Any concerns were addressed immediately. Staff were re-educated on Resident Rights policy. Those currently on leave of absence or PRN will be re-educated on their next scheduled workday. Resident Rights policy was reviewed by QA committee and deemed to be appropriate. Management team will complete quality rounds to evaluate for inappropriate interaction by staff members weekly x4, then monthly x 3. Concerns will be addressed immediately and findings will be reported to the QA committee for further review and recommendations. Administrator is responsible for sustained compliance.