Failure to Provide Compression Stockings per Physician Order
Penalty
Summary
A deficiency occurred when a resident with a history of bilateral lower extremity edema, cellulitis, hypertension, and generalized muscle weakness did not receive compression stockings as ordered by the physician. The resident was cognitively intact and able to make decisions, and the physician's order specified daily application of compression stockings to both lower extremities. During an observation, the resident was found without compression stockings and reported not having them for two weeks, stating that the previous stockings were too long and wide. The resident also indicated that nursing staff were aware of the lack of appropriate stockings during this period and expressed concern about ongoing swelling. Interviews with the treatment nurse and DON confirmed that the resident had not received the prescribed compression stockings for two weeks due to the old stockings being ill-fitting and new ones not being delivered. The treatment nurse acknowledged that the physician's order for daily application was not followed and that untreated edema could result in hospitalization. Facility policy indicated that incorrectly sized stockings could cause harm, but the resident was left without any compression stockings for an extended period, contrary to the physician's order.