Failure to Establish Baseline SpO2 and Oxygen Therapy Parameters for Resident with COPD
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for a resident with chronic obstructive pulmonary disease (COPD) by not identifying a baseline SpO2 (blood oxygen level) and not establishing clear parameters for the use or discontinuation of supplemental oxygen therapy. The resident's care plan and physician orders included the use of an oxygen concentrator at 4 liters per minute via nasal cannula as needed, but did not specify when to initiate or discontinue oxygen, nor did they document the resident's baseline SpO2. The Treatment Administration Record showed SpO2 levels ranging from 91% to 99%, but did not indicate whether supplemental oxygen was in use at the time of these readings. Interviews with nursing staff and the director of nursing confirmed the absence of parameters and baseline SpO2 in the resident's orders and care plan. The director of nursing acknowledged that such information is expected, especially for residents with COPD, due to the risks associated with over-oxygenation. The facility's existing oxygen concentrator policy did not address the identification of baseline SpO2 or provide guidance on parameters for use based on resident-specific risk factors.