Failure to Notify Physician of High Blood Sugar
Penalty
Summary
A deficiency occurred when facility staff failed to notify a physician of a resident's high blood sugar, despite a specific request from the resident's family. The resident, who had a history of diabetes mellitus and diabetic neuropathy, was monitored by his family through a Dexcom system that alerted them to abnormal blood sugar levels. On the night in question, the family received an alert that the resident's blood sugar was 400 and called the facility to request that the nurse notify the physician. The nurse checked the resident, found his blood sugar to be 323, and informed the family but refused to contact the physician, stating that the level was below 350 and that the resident would receive insulin during the morning medication pass. The nurse practitioner's interview confirmed that a blood sugar above 300 is considered high and that the physician should have been notified as per the family's request. The resident's blood sugar was later recorded as 426 during the morning shift, requiring additional insulin coverage. The Director of Nursing acknowledged that the nurse should have called the physician, as the facility's policy requires prompt notification of the physician when there is a significant change in the resident's condition.