Delayed Catheter Reinsertion and Inadequate Bladder Care
Penalty
Summary
A deficiency occurred when a registered nurse (RN) failed to promptly reinsert a foley catheter for a female resident with multiple sclerosis, neuromuscular dysfunction of the bladder, paralytic syndrome, and overactive bladder. The resident's care plan and physician orders indicated the need for an indwelling catheter due to neurogenic bladder, with instructions to maintain and change the catheter as needed. On the morning in question, the resident's catheter was found to have come out, and the certified nursing assistant (CNA) notified the RN. Despite the resident expressing discomfort and a preference for the catheter to be reinserted, the RN delayed replacement for over eight hours, only reinserting the catheter in the afternoon after being prompted by the Director of Nursing (DON). Throughout the day, the resident was unable to sense when she was voiding, which caused her distress. Interviews with staff confirmed that the RN was aware of the situation but chose to postpone the procedure, and the nurse practitioner (NP) stated that such a delay could lead to urinary retention and a distended bladder. The facility was unable to provide a catheter care policy when requested. The failure to provide timely catheter care and adhere to physician orders constituted a deficiency in ensuring appropriate treatment and services to prevent urinary tract infections for the resident.