Failure to Follow Physician's Wound Care Orders
Penalty
Summary
A wound nurse failed to follow a physician's order for wound care for a resident with a trauma-related wound on the right anterior heel. During a bandage change, the nurse removed the dirty dressing and applied a new dry dressing without first cleaning the wound with normal saline solution (NSS) as specifically ordered by the physician. The resident's medical record indicated diagnoses including after care following joint replacement, COPD, seizures, and obstructive sleep apnea, and the resident was assessed as moderately intact for daily decision making. The physician's order required the wound to be cleaned with NSS, patted dry, covered with a non-adherent pad, and wrapped with kerlix dressing on a set schedule. The care plan also directed staff to administer treatments as ordered and follow facility protocols for skin breakdown prevention and treatment. The nurse indicated she believed she had completed the procedure correctly, despite omitting the required wound cleaning step.