Failure to Provide ROM Interventions for Resident with Hand Contractures
Penalty
Summary
A deficiency was identified when a resident with bilateral hand contractures did not receive appropriate interventions to maintain or improve range of motion (ROM) as required. The resident, who had diagnoses including anoxic brain damage, anxiety, and respiratory arrest, was assessed on admission as having both arms contracted to varying degrees and was severely cognitively impaired. The care plan noted the resident was at risk for skin breakdown due to the contractures. Despite this, observations on multiple occasions found the resident lying in bed without any splints or supportive devices, such as carrots, in place to address the contractures. During an interview, the registered nurse responsible for the resident confirmed that the resident had bilateral hand contractures since admission and that no splints or carrots had been used. The facility's contracture prevention policy requires individualized care plans for at-risk residents, including the use of ROM exercises and supportive devices. The lack of implementation of these interventions for the resident with contractures constituted a failure to follow the facility's own policy and to provide necessary care to maintain or improve the resident's ROM.