Failure to Apply Compression Wraps as Ordered and Inaccurate Documentation
Penalty
Summary
A deficiency occurred when nursing staff failed to apply compression wraps to a resident's legs as ordered by the physician for the management of lymphedema. The resident, who had diagnoses including congestive heart failure, morbid obesity, and lymphedema, had a physician's order for bilateral leg compression wraps to be applied every morning and removed every evening. On the day in question, the Treatment Administration Record (TAR) indicated that the wraps were applied at 8:00 AM by a nurse. However, during an interview and observation at 10:00 AM, the resident was found without compression wraps and expressed concern about the omission, stating that staff had previously applied and removed the wraps as ordered. Further investigation revealed that the nurse whose initials appeared on the TAR for the application of the wraps denied applying them and was unsure how her initials were recorded. She also lacked knowledge about the frequency and timing of the wrap application and removal. The Director of Nursing confirmed that physician-ordered tasks should be carried out by nursing staff. The failure to apply the compression wraps as ordered and the inaccurate documentation on the TAR constituted a failure to meet professional standards of quality care.