Failure to Initiate Bowel Protocol for Constipated Resident
Penalty
Summary
The facility failed to initiate bowel interventions as required by its own bowel protocol policy for a resident who experienced constipation. According to the facility's policy, licensed nurses are to monitor residents' bowel movements and initiate interventions if a resident has not had a bowel movement for three days. The policy specifies that after 72 hours without a bowel movement, the nurse should administer Milk of Magnesia, followed by a Dulcolax suppository if there is still no bowel movement by the next shift, and notify the physician if the period exceeds four days. For one resident, who was alert and oriented, documentation showed a gap of approximately 105.5 hours between bowel movements. Review of the Medication Administration Record did not show any medication intervention after 72 hours without a bowel movement. Interviews with nursing staff confirmed that the bowel protocol should have been initiated at the 72-hour mark, but it was not. This lapse was identified through record review and staff interviews, confirming that the facility did not follow its established protocol for bowel management.