Failure to Evaluate and Manage Bowel Function for a Resident
Penalty
Summary
Facility staff failed to evaluate and manage bowel function for a resident with dementia, hypertension, and major depressive disorder, who was dependent on staff for toileting. The resident had physician's orders for daily polyethylene glycol and PRN Senexon-S for constipation. Despite documentation showing no bowel movement for six consecutive days, there was no record of an assessment being performed or the PRN laxative being administered during this period. The resident's comprehensive care plan did not include interventions for constipation. Review of the electronic medical record and medication administration record confirmed the absence of both PRN medication administration and evaluation of bowel function. Interviews with the Unit Manager and DON confirmed the lack of assessment, intervention, and a facility policy on bowel and bladder elimination. The DON stated that staff should utilize PRN laxatives, perform evaluations, or notify the provider when a resident has not had a bowel movement for six days, but this was not done in this case.