Failure to Initiate Bowel Protocol for Resident with Extended Constipation
Penalty
Summary
The facility failed to implement its bowel management protocol for a resident who was moderately cognitively impaired. According to the facility's policy, specific interventions such as administering Polyethylene Glycol, Docusate Sodium, Milk of Magnesia, Sodium Phosphate enema, or Bisacodyl Suppository were to be initiated if a resident had not had a bowel movement for three days. Documentation showed that the resident went over five days without a bowel movement, yet the bowel protocol was not initiated during this period, and there was no documentation of interventions or refusals. Interviews with staff confirmed that an alert should have triggered after three days without a bowel movement and that interventions should have been administered and documented per policy. The Medication Administration Report for the relevant period did not show any bowel interventions provided, and the Director of Nursing was unable to provide further documentation of successful interventions. This lapse resulted in a failure to provide appropriate treatment and care according to physician orders and facility policy.