Failure to Follow Physician Orders for Wound Care
Penalty
Summary
A deficiency occurred when a registered nurse (RN) failed to follow physician orders for wound care treatment for a resident with dementia and Type 2 Diabetes Mellitus, who was also receiving hospice care. The resident was admitted with a pressure-related skin injury and had a care order to wash the right buttock wound with soap and water or wound wash, followed by the application of gauze soaked in Dakins (Sodium Hypochlorite) Solution for five minutes. During an observed wound care procedure, the RN applied the soaked gauze directly to the wound without first cleansing it as specified in the physician's order. The RN acknowledged during an interview that the wound should have been cleansed prior to applying the treatment. The Director of Nursing (DON) also confirmed that the physician's orders were not followed during the wound care procedure. The facility's policy requires treatments to be provided in accordance with physician orders and current standards of practice, which was not adhered to in this instance.