Failure to Provide Wound Care as Ordered by Physician
Penalty
Summary
The facility failed to provide wound care treatments as ordered by the physician for a resident with multiple medical conditions, including diabetes mellitus, chronic kidney failure, and pruritis. The resident's care plan included interventions for eczematous areas and skin tears, with specific physician orders for cleansing and treating the left shoulder, left arm, and right forearm using designated products and techniques. However, observations revealed that the resident had an Optifoam bandage applied to the arm below the right elbow and the left shoulder, which were not ordered by the physician. Additionally, Kerlix dressings on both lower arms were saturated with blood and had not been changed according to the prescribed schedule, as indicated by the dates and staff initials on the dressings. During wound care treatment, an LPN was observed using wound cleanser instead of soap and water, applying Optifoam bandages and Kerlix wraps not specified in the physician's orders, and failing to date or initial some dressings as required by facility policy. The LPN confirmed that the wound care provided did not follow the physician's orders, acknowledging that Xeroform and a non-adherent bandage should have been used on the right arm and Triad cream with open air exposure on the left arm. Review of facility policy confirmed that treatments were to be applied as ordered and dressings were to be properly labeled, which was not done in this case.