Failure to Assess and Manage Pain and Anxiety in Hospice Resident
Penalty
Summary
Licensed nursing staff failed to provide necessary services to a hospice resident in end-of-life transition by not adequately assessing and treating pain and anxiety. The resident, who had a history of restlessness and agitation managed with as-needed lorazepam for anxiety and morphine for pain, received only one dose of morphine and no lorazepam during a 12-hour night shift. Documentation confirmed a 17-hour gap between morphine doses, and there was no record of lorazepam administration for anxiety during this period. The nurse on duty was inconsistent in her account of medication administration and did not recognize that the resident's restlessness could be related to pain or anxiety. Review of the medication administration record and nursing progress notes revealed a lack of documentation regarding assessments or interventions for the resident's restlessness, pain, or anxiety during the shift in question. The absence of timely pain and anxiety management negatively affected the resident's comfort, and the facility's investigation corroborated the neglect of care provided to the resident during this period.