Failure to Monitor and Intervene for Bowel Function
Penalty
Summary
The facility failed to ensure proper monitoring and intervention for bowel function for one resident with a diagnosis of Parkinson's disease and constipation, who also had a history of fecal impaction. According to the facility's bowel program, nursing staff were required to monitor bowel movements every shift and implement a stepwise intervention protocol, including the administration of prune juice, oral laxatives, and suppositories as needed, with physician notification if no bowel movement occurred after three days. Documentation revealed that the resident went multiple periods of four days without a recorded bowel movement, and the required interventions, including the administration of Miralax as ordered, were not provided during the month in question. Interviews with nursing and dietary staff confirmed inconsistent monitoring and communication regarding bowel management. Staff reported that the bowel movement tracking was not consistently completed, and dietary staff were not routinely informed about which residents required prune juice. The DON acknowledged that the documentation was incomplete and that the resident should have received interventions according to the protocol. The resident was eventually admitted to the hospital, and the deficiency was attributed to the lack of consistent monitoring and failure to follow the established bowel management procedures.