Failure to Complete Ordered Wound Care for Skin Cancer
Penalty
Summary
The facility failed to ensure that wound care treatment was completed as ordered for a resident with a right lateral nose skin cancer. The resident, who had a diagnosis of malignant melanoma of the nose along with cognitive communication deficit and weakness, was assessed to have intact cognition. Wound assessments conducted by a nurse practitioner on multiple dates documented a melanoma wound on the right nostril, with specific orders to cleanse the wound daily with normal saline and leave it open to air. A review of the resident's medication and treatment administration records over a period of nearly one month did not show evidence that the prescribed daily wound cleansing was performed. This was confirmed during an interview with the wound nurse, who acknowledged the absence of documentation indicating the treatment was completed as ordered. The facility's policy emphasized the importance of preventing skin impairment and promoting wound healing, but the required wound care was not documented as provided.