Failure to Provide Care and Services for Resident's PICC Line
Penalty
Summary
The facility failed to provide appropriate care and services for a resident with a Peripherally Inserted Central Catheter (PICC) line. Upon admission from the hospital, the resident's transfer form did not indicate the presence of an IV line, but facility staff documented the existence of a PICC line in the resident's right arm. The resident reported that the facility did not use the PICC line for medication administration, nor did staff flush the line or change the dressing. Observation confirmed that the PICC dressing was dated prior to the resident's admission, indicating it had not been changed during her stay. There were no physician orders in the electronic medication administration record (EMAR) for dressing changes, saline flushes, or site assessments for the PICC line. Further review revealed that a physician order to remove the midline was marked as completed in the EMAR, despite the PICC line not being removed. Nursing staff confirmed that the PICC line had not been flushed or assessed, and the dressing had not been changed as required. The Director of Nursing acknowledged that the admitting nurse failed to enter necessary orders for the PICC line and that the resident's chart had not been audited to ensure proper care orders were in place. As a result, the facility did not provide the required care and monitoring for the resident's central line.