Delayed Assessment and Treatment of Urinary Tract Infection
Penalty
Summary
A deficiency occurred when the facility failed to timely assess and obtain necessary treatment for a resident who exhibited symptoms of a urinary tract infection (UTI). The resident, who had chronic atrial fibrillation, hypothyroidism, congestive heart failure, moderate cognitive impairment, and was always incontinent of urine, was dependent on staff for toileting. On one occasion, the resident's representative reported to an LPN that the resident was experiencing burning during urination. Although the LPN stated she notified the nursing coordinator and intended to order a urinalysis with culture and sensitivity, there was no documentation in the medical record of these actions or of the resident's symptoms at that time. The resident's symptoms were not addressed in the medical record until several days later, when a new order for a urine specimen was obtained and the family was notified. The urine sample was not collected until three days after the order, and the results, which confirmed a bacterial infection, were not reported until several days after that. Antibiotic treatment was initiated twelve days after the initial report of symptoms. Interviews with staff and the Director of Nursing confirmed the lack of timely documentation and response to the resident's symptoms, resulting in a delay in assessment and treatment.