Failure to Care Plan for Smoking Risk with Oxygen Use
Penalty
Summary
The facility failed to develop and implement a care plan addressing a resident's ongoing nicotine dependence and stated intent to continue smoking, despite the resident's use of oxygen therapy and multiple documented behaviors indicating a desire to smoke. The resident, who had diagnoses including nicotine dependence and chronic obstructive pulmonary disease, repeatedly expressed intentions to smoke while on oxygen and was observed attempting to obtain cigarettes and expressing frustration over smoking restrictions. Staff were aware of the resident's behaviors and risk factors, as evidenced by nursing and behavioral notes, but did not include these issues in the resident's care plan. This lack of care planning resulted in staff being unaware of or unprepared for the resident's actions, culminating in a serious incident where the resident's wheelchair caught fire while the resident was outside, leading to burns on the resident's upper legs, abdomen, nostrils, and hands. Documentation shows that the resident had been counseled about the dangers of smoking with oxygen and had been prescribed nicotine replacement therapy, but no formal interventions or monitoring were established in the care plan to address the risk of smoking while using oxygen.