Failure to Provide Timely Wound Dressing Changes
Penalty
Summary
Surveyors found that the facility failed to provide wound care in accordance with physician orders and professional standards for one resident. The resident, who had diagnoses including peripheral vascular disease, anxiety, and depression, was observed with a soiled dressing on the right ankle that was dated three days prior. The dressing was only partially covering the open wound and had visible yellow/brown drainage. Documentation in the Medication Administration Record indicated that nurses had recorded daily dressing changes as ordered, but direct observation by surveyors contradicted these records. Interviews with nursing staff confirmed that the dressing should have been changed daily according to the physician's orders. The Director of Nursing also stated that her expectation was for nurses to follow the physician's orders for dressing changes. The facility's policy on dressings did not specify adherence to physician orders, and the failure to change the dressing as required resulted in the resident having a soiled and exposed wound for at least three days.