Failure to Perform Pre-Respiratory Assessment Prior to Nebulizer Treatment
Penalty
Summary
A deficiency occurred when a registered nurse (RN) failed to perform a pre-respiratory assessment prior to administering a nebulizer treatment to a resident. According to facility policy, a pre-treatment lung assessment, including auscultation of breath sounds with a stethoscope, is required before administering nebulizer therapy. During the observed administration, the RN applied gloves and began the nebulizer treatment without first listening to the resident's lung sounds. The RN acknowledged this omission when questioned and stated that the assessment would be performed after the treatment. The resident involved had been admitted with diagnoses including iron deficiency anemia secondary to blood loss, bipolar disorder, and major depressive disorder, and had a physician's order for albuterol sulfate nebulizer treatments for cough. The Director of Nursing confirmed that the expectation is for nurses to complete both pre- and post-treatment lung assessments using a stethoscope to monitor the effectiveness of the therapy. The failure to perform the required pre-treatment assessment constituted a deviation from facility policy and standard practice.