Failure to Administer Bowel Care and Follow Physician Orders
Penalty
Summary
The facility failed to administer bowel care medication and follow physician orders for bowel management for one resident with severe cognitive impairment and diagnoses including dementia and multiple sclerosis. The facility's constipation protocol required specific interventions and physician notification if more than four days passed without a bowel movement. However, the resident experienced two separate periods of extended constipation—one lasting seven days and another lasting five days—without consistent administration of prescribed bowel care medications or documentation that the physician was notified as required. Review of the medication administration records showed that the resident received a Dulcolax suppository only after seven days without a bowel movement, and there was no evidence of bowel care medication being given during the second episode. Additionally, there was no documentation of monitoring, implementation of the bowel protocol, or physician notification for either occurrence. Interviews with nursing staff confirmed that the protocol was supposed to be followed, but no evidence was provided to show that it was implemented for this resident.