Failure to Apply Splints as Ordered for Residents with Limited Range of Motion
Penalty
Summary
The facility failed to ensure that splints were applied as ordered by the physician for two residents with limited range of motion. One resident with a history of a right distal radius fracture and diagnoses including paroxysmal atrial fibrillation, osteoporosis, and osteoarthritis, was observed multiple times without the prescribed right wrist splint in place. The resident reported that staff had previously applied the splint but could not recall the last time it was used. The physician order and care plan specified that the splint should be applied daily, with removal only for bathing, sleeping, writing, or physical therapy, yet observations confirmed the splint was not in use during the review period. Another resident with left-sided hemiplegia following cerebrovascular disease and a left hand contracture was also observed multiple times without the ordered left arm/hand splint. The care plan and physician order required daily application of the splint, with removal at bedtime and for skin checks. Staff interviews confirmed awareness of the orders and the importance of splint use to prevent contractures, but the splints were not applied as directed. The facility's contracture prevention policy required contracture prevention appliances to be applied as ordered, but this was not followed for these residents.