Failure to Honor Resident's Right to Refuse Blood Draw
Penalty
Summary
The facility failed to honor a resident's right to refuse treatment when staff attempted to draw blood from a resident who had previously indicated refusal. The resident, who had diagnoses including dementia, anxiety, and osteoarthritis, was assessed as having severely impaired cognition and was dependent on staff for daily activities. Despite physician orders and signage above the resident's bed instructing staff to call the family if the resident refused a blood draw, staff proceeded with the procedure after the resident expressed refusal. Observations and interviews revealed that the resident verbally told staff to stop during the blood draw, but staff continued and completed the procedure. The resident reported that staff held her down and did not listen to her refusal, resulting in pain and bruising on both wrists. Documentation showed that the resident had a history of refusing care, and the care plan included interventions to encourage the resident to verbalize feelings and offer understanding and empathy. Staff interviews confirmed that the protocol was to call the family if the resident refused a blood draw, and that residents should not be forced to accept care. However, the staff involved were either unaware of the signage or did not follow the established protocol. Facility policies reviewed indicated that residents have the right to refuse treatment and should not be compelled by force, but these policies were not followed in this instance.