Catheterization Performed Without Physician Order or Consent
Penalty
Summary
A deficiency occurred when nursing staff performed a straight catheterization on a resident without obtaining a physician's order or the resident's consent. The incident involved two nurses who, during the early morning hours, inserted a catheter to collect a urine sample after the resident declined to walk to the bathroom. The resident, who was cognitively intact as indicated by a BIMS score of 15, reported that the procedure was done without explanation or consent, leading the resident to feel violated and contact local authorities. Review of the medical record showed that while there was a physician's order for laboratory tests including urinalysis, there was no specific order for straight catheterization. Facility policy required a physician's order for all catheterizations, and staff interviews confirmed that both an order and resident consent were necessary for the procedure. The DON acknowledged that the catheterization was performed based on nursing judgment rather than a physician's directive, in direct contradiction to facility policy.