Failure to Follow Physician's Orders for Bowel Protocol
Penalty
Summary
Facility staff failed to follow physician's orders regarding a bowel protocol for a resident with dementia who was always incontinent of bowel and required assistance with daily care needs. The resident had a physician's order to receive 5 ounces of Fiberjuice as needed for constipation if no bowel movement occurred by the second day. Bowel movement records showed that the resident did not have a bowel movement for several consecutive days on two separate occasions. There was no documented evidence that Fiberjuice was offered to or refused by the resident after the second day without a bowel movement, as required by the physician's order. An interview with the Director of Nursing confirmed that staff did not adhere to the facility's bowel policy or the physician's orders for the resident on the specified dates. The deficiency was identified through a review of facility policy, clinical records, and staff interviews, and was cited under 28 Pa. Code 211.12(d)(5) Nursing Services.