Failure to Label and Change Respiratory Tubing as Required
Penalty
Summary
The facility failed to provide necessary and appropriate respiratory care for a resident with emphysema and COPD, as evidenced by the lack of proper labeling and dating of oxygen and nebulizer tubing. Observations over two consecutive days revealed that the resident's oxygen tubing and nebulizer tubing were not labeled or dated, despite the resident requiring continuous oxygen and intermittent nebulizer treatments. The resident was unable to recall when the tubing was last changed, and there was no documentation or visible indication of when the equipment had been replaced. A review of the resident's medical record showed a physician's order to change the nasal cannula weekly, but this order was not transcribed onto the Medication Administration Record or Treatment Administration Record. There were also no physician orders to change the nebulizer tubing, and the care plan did not include interventions for changing respiratory equipment. Interviews with staff, including an LPN and the DON, confirmed that facility policy required weekly changes, labeling, and dating of respiratory tubing, but these procedures were not followed for this resident. The facility's policy specified that both oxygen and nebulizer tubing should be changed every seven days to prevent infection.