Failure to Follow Physician's Orders for Catheter Irrigation
Penalty
Summary
A deficiency occurred when a resident with an indwelling catheter and multiple diagnoses, including Multiple Sclerosis, Dementia, and neuromuscular dysfunction of the bladder, did not receive catheter care in accordance with the physician's orders. The physician had ordered daily irrigation of the catheter using 30 ml of 0.25% acetic acid solution, with instructions to clamp the catheter for 30 minutes after instillation, then flush with sterile water. However, nursing staff performed the irrigation by instilling the solution and immediately allowing it to drain into the bag, without clamping the catheter or waiting the required 30 minutes before flushing. This deviation from the prescribed procedure was confirmed during interviews with the nurse responsible for the resident's care, who acknowledged not following the specific order to clamp the catheter and wait before flushing. The Assistant Director of Nurses also confirmed that the nurse had not performed the catheter irrigation as ordered. Facility policy on catheter irrigation was available, but the required steps in the physician's order were not followed for this resident.