Failure to Provide Timely Wound and Catheter Care
Penalty
Summary
The facility failed to provide wound and indwelling catheter care according to physician orders and facility policy for a resident who was admitted with multiple fractures, a subarachnoid hemorrhage, an external fixator, and an indwelling catheter. Upon admission, the resident required staff assistance for most activities of daily living and had documented needs for surgical wound care and catheter care. However, wound care orders for the external fixator were not obtained until four days after admission, and catheter care orders were not obtained until seven days after admission, coinciding with the resident's discharge. Documentation showed that wound care for the external fixator was not completed for the first four days, and there was no documented catheter care during the resident's stay. Collateral contact reported that the resident's surgical dressing was not changed for extended periods and catheter care was not performed, leading to the resident leaving the facility against medical advice. The Director of Nursing confirmed that although the catheter and external fixator were identified on the care plan and admission assessment, treatment orders were not promptly obtained, and there was no documentation of care provided for the indwelling catheter or the external fixator until several days after admission.