Failure to Provide Required Emergency Dialysis Supplies at Bedside
Penalty
Summary
The facility failed to ensure the availability of necessary emergency supplies for a resident who required hemodialysis. The resident, who had end-stage renal disease and was dependent on hemodialysis, had a physician's order and care plan intervention requiring an emergency kit to be present at the bedside. This kit, intended to address complications such as bleeding from the arteriovenous (AV) fistula site, was not found at the resident's bedside during an observation, despite documentation on the Medication Administration Record indicating it was present. The resident, who was cognitively intact, confirmed the absence of the emergency supplies after returning from dialysis. Staff interviews further confirmed that the emergency supplies were not available in the resident's room as required. An LPN acknowledged that the supplies should have been at the bedside and typically are kept on the back of the resident's headboard. The Nursing Home Administrator also confirmed the failure to ensure the emergency dialysis access supplies were available as ordered and required by the resident's care plan. This deficiency was identified through observation, record review, and staff and resident interviews.