Failure to Provide Adequate Orientation and Competency Training for Nursing Staff
Penalty
Summary
Nursing staff at the facility were scheduled to work independently with residents without adequate orientation or competency-based training. Two LPNs reported that they did not receive an orientation checklist or formal training before being assigned to care for residents on their own. One LPN stated he did not follow another nurse or complete any orientation checklist, and his personnel file lacked documentation of orientation or training. Another LPN reported receiving some instruction on medication times and paperwork but did not receive competency-based training on specific clinical skills such as catheter care, enteral tubes, or tracheostomy care, despite being expected to perform these tasks. His personnel file also lacked an orientation or training checklist. A former RN at the facility confirmed that there was no checklist for orienting new staff and expressed concerns about the competency and readiness of new hires, specifically noting that one LPN was allowed to work independently despite her concerns about his abilities. The facility administrator acknowledged the absence of a formal orientation or training program, and the DON stated that while a process was being developed, there was no formal orientation list in place. Facility policy required a 10-hour orientation program with a checklist for all new hires, but this was not followed or documented for the staff reviewed.