Delay in Completion of Ordered Urinalysis
Penalty
Summary
The facility failed to ensure that a physician-ordered urinalysis with culture and sensitivity was completed in a timely manner for a resident diagnosed with neuromuscular dysfunction of the bladder. The order for the urinalysis was placed on 02/18/25, but the urine specimen was not collected until 02/21/25. There was no documentation explaining the delay in specimen collection. Nursing notes indicated that the resident exhibited behavioral changes, which the resident's representative associated with urinary tract infections, prompting further communication with the nurse practitioner and a new order for the urinalysis. Interviews with facility staff confirmed that nurses were responsible for collecting urine specimens and notifying the laboratory for pick-up, with the expectation that such orders should be completed the same day they are received. The ADON confirmed that the order was entered into the lab system on the day it was written, but the specimen was not collected until three days later, and there was no documentation to account for the delay. The DON also stated that while there is no specific time frame for completing urinalysis orders, the expectation is for same-day completion, and any inability to collect a specimen should be documented in the resident's notes.