Failure to Provide Ordered Splint Application for Resident with Limited Mobility
Penalty
Summary
The facility failed to ensure that a resident with a physician's order for bilateral knee splint application received the prescribed restorative care. The order specified that the Restorative Nurse Assistant (RNA) was to apply splints to both knees for one hour, five times a week. Review of the resident's medical record and RNA task documentation over a 30-day period revealed that there was no documentation indicating the splints were applied as ordered. The RNA confirmed during interview and record review that there was no record of the splints being applied, and acknowledged the importance of the splints in maintaining form and preventing contractures. The resident involved had diagnoses including muscle weakness, an artificial hip joint, and a contracture of the left lower leg. The resident was dependent on staff for toileting, bathing, and dressing the lower body, and had intact cognition and decision-making capacity. The care plan reflected the physician's order for splint application to maintain function. The facility's policy required restorative nursing care to promote optimal safety and independence, but the lack of documentation and apparent failure to provide the ordered care constituted a deficiency.