Failure to Implement Restorative Nursing Program for Resident with Mobility Impairment
Penalty
Summary
A deficiency occurred when the facility failed to implement a restorative nursing program as recommended by therapy for a resident with impaired lower extremity mobility. The resident, who was cognitively intact and had no upper extremity impairment but did have lower extremity impairment, reported only participating in restorative exercises once. The care plan indicated a need for restorative programming to maintain functional mobility and prevent decline, with specific interventions outlined, including the use of a seated bike, sit-to-stand activities, and lower extremity strengthening and stretching exercises. Despite these documented interventions, staff interviews revealed inconsistent implementation of the restorative program. The staff member primarily responsible for restorative care was frequently reassigned to other duties, such as providing showers, and could not explain how restorative programming was completed when working on the floor. No other staff were officially assigned to restorative programming, and coverage was sporadic. The Restorative Nurse's involvement was limited to documentation assistance, and the Director of Nursing stated that nurses were expected to fill in if the primary staff was unavailable. The facility's policy allowed for restorative nursing care upon discharge from therapy, but the recommended program was not consistently followed.