Failure to Provide Colostomy Care and Services per Professional Standards
Penalty
Summary
The facility failed to provide colostomy care and services consistent with professional standards of practice for one resident. The facility's policy required that residents needing colostomy services receive care that prevents skin exposure to fecal matter. The resident in question had a history of peritoneal abscess, end-stage renal failure, dependence on dialysis, and a colostomy. A physician's order was in place for the colostomy appliance to be changed every three days and as needed. However, the resident's care plan did not address the specific needs related to the colostomy, such as the type and size of the appliance or collection bag required for maintenance. The resident reported not having a colostomy appliance or bag in place for weeks and stated that requests for an appliance before dialysis were not fulfilled. Instead, the resident was sent to dialysis wearing only an adult brief, allowing the colostomy to drain directly into it. Interviews with facility staff indicated that the resident frequently refused colostomy care, but there was no documentation in the clinical record to support this claim. The deficiency was identified through a review of clinical records, facility policy, and interviews with the resident and staff.