Failure to Maintain Emergency Dialysis Supplies at Bedside
Penalty
Summary
The facility failed to ensure the ready availability of necessary emergency dialysis supplies for a resident receiving hemodialysis. According to the care plan for the resident, who had chronic kidney disease and acute kidney failure and received hemodialysis via a right chest perma-Cath, an emergency kit containing pressure dressing, tape, and a clamp was required to be at the bedside on the wall. This intervention was intended to provide immediate access to supplies in the event of complications such as hemorrhage or catheter dislodgement. However, during an observation, surveyors found that the emergency kit was not present or accessible in the resident's room, and there were no visible emergency clamps or pressure dressings as directed by the care plan. Staff interviews confirmed that the emergency kit should have been present and accessible, in accordance with both the resident's care plan and facility policy. The Nursing Home Administrator also verified that facility policy required emergency kits to be maintained in the rooms of residents receiving hemodialysis. The absence of these critical emergency supplies constituted a failure to follow the individualized care plan and facility policy for a resident with significant renal conditions requiring hemodialysis.