Failure to Complete Respiratory Assessments and Replace Nebulizer Equipment Weekly
Penalty
Summary
The facility failed to ensure that respiratory assessments were completed for a resident receiving nebulizer treatments and did not replace respiratory equipment on a weekly basis as required. Observation revealed that a nebulizer machine at the resident's bedside had a handheld mouthpiece that was neither bagged nor dated. Record review showed that the resident, who had diagnoses including anxiety and cough, was receiving Duoneb Solution via nebulizer twice daily per physician order. However, there was no documentation in the clinical record of respiratory assessments being performed before and after the treatments, nor was there evidence of weekly replacement of the nebulizer tubing, chamber, and mouthpiece. Interviews with staff confirmed that the nebulizer tubing should be dated and bagged when not in use and that equipment was to be replaced weekly. The DON acknowledged that respiratory assessments were expected to be completed before and after treatments to assess effectiveness, but confirmed that such assessments were not in place for this resident. Facility policy required collection of respiratory data pre- and post-treatment, but this was not documented in the resident's record.