Failure to Schedule Ophthalmologist Consultation for Cataract Surgery
Penalty
Summary
A deficiency occurred when the facility failed to schedule an ophthalmologist consultation for cataract extraction surgery as ordered for a resident with impaired vision. The resident, who was cognitively intact and used glasses, had a diagnosis of age-related cataracts in both eyes, with the right eye causing blurred vision and increasing fall risk. An optometrist recommended in November that the facility select a local ophthalmologist for cataract extraction, and the Medical Director initialed the consultation. However, there was no documented appointment with an ophthalmologist or follow-up on the recommendation until a new order was placed in March of the following year. Interviews with staff revealed that the optometrist's recommendation was not communicated to the appropriate personnel responsible for scheduling appointments. The Unit Manager, Unit Secretary, and Director of Nursing were all unaware of the initial referral, and the new Social Worker stated that the system for managing outside consultant recommendations was still being developed. The resident reported having to repeatedly request assistance before finally being seen by an ophthalmologist. The deficiency was attributed to a breakdown in communication and follow-up regarding the optometrist's recommendation and physician order.