Failure to Administer Bowel Care Medications as Ordered
Penalty
Summary
The facility failed to follow professional standards of practice for bowel and bladder care for one resident with multiple diagnoses, including congestive heart failure, diabetes, and constipation. The resident had poor decision-making abilities and required cues and supervision. Physician orders specified a bowel care protocol involving Milk of Magnesia (MOM) after two days without a bowel movement, followed by a Dulcolax suppository if MOM was ineffective, and then a Fleets enema if needed, with physician notification if there was still no result. Despite these orders, the resident did not have a bowel movement for nine consecutive days, as documented in the bowel movement records. During this period, the medication administration record showed that no bowel care medications were administered. The Director of Nursing confirmed that the resident should have received MOM after two days without a bowel movement and that the physician should have been notified prior to a recent visit.