Failure to Promote Resident Dignity During Care and Environment Management
Penalty
Summary
The facility failed to promote dignity for two residents as evidenced by direct observations and staff interviews. One resident, who was moderately cognitively impaired and admitted with a nontraumatic intracranial hemorrhage, was observed attempting to eat chocolate pudding without a spoon. As a result, the resident had pudding on his face, nose, clothing, and bed linens. The resident stated he was not given a spoon, and staff confirmed that this situation was a dignity concern, as the resident had to lick the pudding from the bowl, leading to soiling and potential embarrassment. Another resident, who was cognitively intact and admitted with end stage renal disease and an open wound to the lower leg, was found to have a wound VAC device with a half-full canister of old, foul-smelling serous drainage left on the bedside nightstand. The drainage container was visible from the doorway and not in use. Staff, including an LPN and the DON, confirmed that leaving the wound VAC and its contents visible in the room after it was discontinued was a dignity concern, as the drainage was not covered and should have been properly disposed of.