Failure to Provide Physician Order and Proper Care for CPAP/BIPAP Use
Penalty
Summary
The facility failed to provide appropriate respiratory care services for a resident who used a CPAP/BIPAP machine. The resident, admitted with a diagnosis of obstructive sleep apnea, was observed using a BIPAP machine at her bedside and reported cleaning and maintaining the device herself. Upon review of the resident's electronic medical record, it was found that there was no physician's order for the use of the CPAP/BIPAP machine at the time of observation, despite documentation from a recent hospital history and physical indicating the resident's use of such a device. A physician's order was not obtained until several days after the resident's admission. Additionally, interviews with licensed nurses revealed a lack of knowledge regarding the proper cleaning procedures for the CPAP/BIPAP machine. One nurse stated she would need to consult the Director of Nursing about the facility's policy, while another admitted to not knowing how to clean the device. The facility's policy requires that CPAP/BIPAP devices be administered as ordered by a physician and that interventions be implemented to minimize associated risks, but these procedures were not followed in this case.