Delayed Physician Notification of Abnormal Lab Results
Penalty
Summary
Nursing staff failed to promptly notify the physician of abnormal laboratory results for one resident with significant medical conditions, including diabetes and a malignant brain neoplasm, who was also immunocompromised due to chemotherapy. The facility's policy required nursing to recognize changes in condition and notify the physician as soon as such changes, including abnormal lab results, were identified. Despite this, a urine culture showing greater than 100,000 colonies per milliliter of Enterococcus faecalis was not communicated to the physician until two days after the result was available, and only after surveyor inquiry. There was no documentation to support earlier notification. Additionally, the facility was unable to provide documentation that a urinalysis or culture and sensitivity test had been completed for the resident during a specified month, despite active physician orders for these tests. Staff interviews confirmed that abnormal lab results should be communicated to the physician on the same day they are received, and acknowledged that this did not occur in this instance. The deficiency was cited under 28 Pa. Code 211.12 (d)(3)(5) Nursing services.