Incomplete Physician Orders for CPAP Therapy
Penalty
Summary
The facility failed to ensure that physician orders for CPAP (Continuous Positive Airway Pressure) therapy included complete and specific settings for two residents. For both residents, the care plans indicated the use of CPAP as an intervention for conditions such as chronic respiratory failure with hypoxia, obstructive sleep apnea, and ALS. However, a review of the clinical physician orders revealed that the orders lacked essential details such as pressure, ramp time, and humidity settings. In one case, the order simply stated 'CPAP when sleeping - every night shift' without specifying any settings, and in another, the order referenced 'current settings' or 'per home settings' without documentation of what those settings were. The facility's policy required verification of the practitioner's order, including all necessary settings, before initiating CPAP therapy. During interviews, the DON confirmed that the physician orders for both residents did not include the required specifications and acknowledged that staff could not identify or interpret 'per home settings.' The lack of complete and specific physician orders for CPAP therapy was observed for both residents, despite their documented need for this respiratory intervention.