Failure to Implement Timely Bowel Management Interventions
Penalty
Summary
The facility failed to provide necessary care and services for a resident who did not have a bowel movement (BM) for more than three days. According to the facility's bowel regimen management policy, nursing staff are required to review bowel records daily, monitor for no BM for more than 72 hours, and implement interventions as needed, including notifying the physician. In this case, the resident had no BM from 6/1 to 6/6, but interventions were not implemented until 6/6, despite daily monitoring requirements. The resident's medical record showed orders for various laxatives and interventions, but these were not administered in a timely manner according to the policy. The resident exhibited signs of constipation, including abdominal distention, increased agitation, and distress, and required multiple interventions, including enemas and oral laxatives, which were ultimately ineffective. The physician was notified after 72 hours without a BM, and a KUB x-ray confirmed moderate constipation. The resident was subsequently sent to an acute care hospital for disimpaction after seven days without a sufficient BM. The delay in implementing appropriate interventions as outlined in the facility's policy contributed to the deficiency.