Improper Storage of Respiratory Equipment and Failure to Bag Oxygen and Nebulizer Supplies
Penalty
Summary
The deficiency involves the facility’s failure to ensure respiratory equipment was properly stored and bagged when not in use, as required by physician orders and infection control practices. During observation, a resident who was not in their room had a nasal cannula lying loose on a recliner and a nebulizer mask with attached tubing lying on a cart under the window, both unbagged. Physician orders dated 01/10/25 directed that the resident receive albuterol sulfate inhalation solution via nebulizer, and orders dated 07/04/25 specified continuous oxygen at two liters via an oxygen concentrator, including instructions to store tubing and mask in a dry protective cover when not in use. The resident’s significant change assessment, dated 11/17/25, documented admission with diagnoses including congestive heart failure and anemia, moderately impaired cognition with a BIMS score of 11, dependence for transfers, wheelchair use for ambulation, and use of oxygen therapy. When interviewed, an LPN confirmed the resident had continuous oxygen and routine breathing treatments and acknowledged the nasal cannula was lying on the chair and should have been hung on the machine. The ADON, after viewing the room, confirmed that both the nasal cannula and nebulizer mask were not bagged and stated they should have been bagged when not in use for infection control and that the resident required staff assistance for transfers and portable oxygen use.
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