Failure to Provide Incontinence Care and Assistance with ADLs
Penalty
Summary
A deficiency occurred when a resident, who was dependent on staff for all activities of daily living due to hemiplegia following a stroke, was not provided with necessary incontinence care and assistance to bed. The resident, who was always incontinent of bladder and bowel and required two staff members and a mechanical lift for transfers, requested help after soiling her brief. Despite activating her call light and requesting assistance, two nurse aides assigned to her care refused to provide the needed care after a disagreement regarding the room temperature and the resident's use of a curse word. The nurse aides admitted in interviews that they left the resident without care because they felt disrespected by her language. As a result, the resident remained in her wheelchair for several hours, waiting for the next shift to arrive. When the night shift nurse aides eventually assisted her, they found that she was still in her wheelchair, visibly upset, and had been incontinent for some time, with dried and caked fecal matter present. Interviews with additional staff, including the nurse on duty and the Director of Nursing, confirmed that the resident was not assisted to bed or provided incontinence care as required. The staff acknowledged that care should have been provided regardless of the resident's behavior, and that the refusal to provide care was not acceptable. The incident was corroborated by multiple staff interviews and direct observation of the resident's condition.