Failure to Monitor Bowel Movements After Hospitalization for Bowel Obstruction
Penalty
Summary
Facility staff failed to monitor bowel movements for a resident who had recently been hospitalized for a small bowel obstruction. The resident required total assistance with toileting and was always incontinent of bowel and bladder. Despite this, there was no documentation addressing the small bowel obstruction, abdominal assessments, or bowel movements in the resident's progress notes for an extended period following readmission. The resident's care plan identified bowel incontinence related to immobility, but a trial toileting plan was not attempted, and there were multiple consecutive days without a recorded bowel movement. Interviews with staff, including the DON, RN, and LPNs, revealed that the facility did not have a consistent process for monitoring bowel movements. The night shift was supposed to generate a report of residents who had not had a bowel movement in three days and provide it to the day shift, but this process was not followed. Staff confirmed that such reports were not provided, and the DON acknowledged that bowel movements should have been monitored for the resident after hospitalization for bowel obstruction.