Failure to Monitor and Maintain Midline IV Catheter
Penalty
Summary
The facility failed to properly monitor and care for a midline peripheral intravenous catheter for a resident who was admitted with multiple diagnoses, including a lumbar vertebra fracture, dependence on renal dialysis, and gait abnormalities. The resident was receiving intravenous antibiotics and had a midline catheter inserted, but the transparent dressing covering the site was observed to have a gauze dressing underneath that was stained with dried blood and obscured the insertion site. The Director of Nursing confirmed the presence of the soiled gauze and acknowledged that the dressing should have been changed according to protocol. There was no care plan in place for the resident's midline intravenous line, and there was no documentation that the circumference of the resident's arm was being measured as required. Additionally, prior to a certain date, there was no evidence in the Medication Administration Record or Treatment Administration Record that the midline line was being flushed or monitored every shift. The facility's own policy required regular dressing changes, monitoring for infection and bleeding, and measurement of arm circumference, none of which were consistently documented or performed.