Failure to Provide Routine Diabetic Foot Checks
Penalty
Summary
A deficiency was identified when a resident with type 2 diabetes mellitus, peripheral vascular disease, and acute osteomyelitis of the left ankle and foot was not provided routine diabetic foot checks as required by professional standards of practice. The resident was dependent on staff for lower extremity care, including dressing and footwear, and had moderate cognitive impairment. Despite the resident's medical conditions and care needs, there was no policy in place for diabetic foot checks, and neither the physician orders nor the care plan included daily foot inspections until several days after admission. Interviews with nursing staff and the Director of Nursing revealed that foot checks for diabetic residents are expected to be documented in the Treatment Administration Record (TAR). However, review of the resident's TAR confirmed that foot checks were not listed or documented prior to the addition of the order and care plan intervention. Staff acknowledged that if foot checks are not documented in the TAR, they are not completed, resulting in the resident not receiving the required daily foot assessments.