Failure to Ensure Timely Physician Notification and Wound Care as Ordered
Penalty
Summary
The facility failed to provide services in accordance with professional standards of practice for two residents. For one resident with a history of gastro-esophageal reflux disease, hypertension, delusional disorder, and cellulitis, there was a delay in obtaining an antibiotic for a tooth abscess. After returning from a medical appointment with a recommendation for an antibiotic, the nurse contacted the resident's physician and left a message but did not follow up the next day. The oncoming nurse was not made aware of the situation, and the issue was not documented in the 24-hour report as required. The physician was not contacted again until several days later when the resident complained of pain and swelling, at which point an antibiotic was finally ordered. Another resident with quadriplegia, pain, hypertension, urinary tract infection, and multiple stage 4 pressure ulcers did not receive wound care as ordered on several documented dates. The treatment nurse, who worked weekdays, stated that floor nurses were responsible for treatments in her absence, and the RN supervisor was responsible on weekends. However, there was no documentation that wound care was provided on specific dates, and this was confirmed by the DON. The lack of timely follow-up and communication among staff led to missed treatments and a delay in physician notification for necessary care.