Failure to Provide Bowel Management Interventions for a Resident
Penalty
Summary
A deficiency occurred when the facility failed to provide appropriate interventions for bowel management for one resident with a history of constipation. The resident had diagnoses including dementia, anxiety, hypertension, and constipation, and was noted to have moderately impaired cognition but remained independent in activities of daily living. The care plan directed staff to administer medications as ordered, monitor for side effects of constipation, report changes in bowel patterns to the physician, and document daily bowel movement patterns. Standing orders and physician orders were in place for the administration of stool softeners and laxatives, with instructions to notify the physician if there was no result after specific interventions. Despite these directives, the resident's bowel monitoring record showed an eight-day period without a documented bowel movement, and the medication administration record lacked evidence that interventions were provided during this time. There was also no documentation of a bowel assessment for the period in question. Staff interviews confirmed that there were procedures for reporting and initiating standing orders after three days without a bowel movement, but the records did not reflect that these actions were taken for the resident during the identified period. The facility's policy required assessment and intervention for bowel dysfunction, but these were not documented as completed.