Failure to Properly Store Respiratory Equipment for Resident with COPD
Penalty
Summary
The facility failed to ensure that a resident requiring respiratory care received such care in accordance with professional standards, the resident's care plan, and the resident's preferences. Specifically, the resident, who had a history of COPD and hypertension and was assessed as having moderately impaired cognition, was observed to have her oxygen tubing left unbagged on her bed and her nebulizer mouthpiece left unbagged on her bedside table when not in use. The resident reported that she removed her oxygen tubing and placed it on her bed when leaving for smoke breaks and typically placed the nebulizer mouthpiece on the bedside table after use. Staff interviews confirmed that the charge nurse was responsible for bagging the mouthpiece after medication administration, and that the resident often left respiratory items exposed after use. Record review showed that the resident's care plan included interventions for continuous oxygen via nasal cannula and noted a risk for infection due to non-compliance with nasal cannula use, with instructions for nursing to monitor and replace the cannula if found on the floor. Facility policy required nebulizer equipment to be stored in a plastic bag with the resident's name and date, but the policy on oxygen tubing storage was unclear. Staff interviews indicated inconsistent understanding and implementation of proper storage procedures for respiratory equipment, resulting in the resident's respiratory items being left exposed and not stored in accordance with infection control standards.