Delay in Notification and Treatment for Positive Influenza A Result
Penalty
Summary
A deficiency occurred when the facility failed to provide timely medical evaluation and treatment for a resident who tested positive for Influenza A. The laboratory report indicated a positive result for Influenza A, but there was no documented evidence that nursing staff reviewed or addressed these results on the day they were received or the following day. Additionally, there was no documentation that the physician was notified of the positive test result during this period. As a result, antiviral treatment with Tamiflu was not initiated until two days after the positive result was available. The resident involved had significant medical conditions, including malignant neoplasm of the cerebellum, diabetes mellitus, multiple sclerosis, thrombocytopenia, and severely impaired cognition. Interviews with facility staff confirmed that the delay in treatment was due to a lack of timely communication from nursing staff to the physician. Staff also acknowledged that droplet precautions could have been implemented sooner, as a physician's order is not required to begin such precautions when Influenza is suspected or confirmed. The delay in starting Tamiflu and implementing appropriate precautions represented a failure to provide necessary care and services according to the facility's own Influenza protocol and CDC guidelines.