Unbagged BiPAP Mask and Oxygen Tubing for Resident Requiring Respiratory Support
Penalty
Summary
The deficiency involves the facility’s failure to provide respiratory care consistent with professional standards, the resident’s care plan, and physician orders for one resident who required BiPAP and continuous oxygen therapy. The resident was an older female with mild persistent asthma and a respiratory disorder, cognitively intact with a BIMS score of 15, and care plans and physician orders specifying continuous oxygen at 2–3 L via nasal cannula and noninvasive ventilation via BiPAP face mask at bedtime and as needed during naps. During an observation, the resident was asleep in her wheelchair receiving oxygen from a portable tank, while the oxygen tubing connected to her oxygen concentrator lay unbagged on the floor and the BiPAP mask was unbagged on the nightstand. Staff interviews confirmed that these respiratory items should have been stored in bags when not in use to prevent infection. An LVN acknowledged that the BiPAP mask and oxygen tubing should have been bagged, stated that the resident removed the BiPAP mask herself, and indicated that the tubing found on the floor would need to be discarded and replaced. The DON and ADON both stated that nurses were responsible for ensuring respiratory items were bagged when not in use, and that any staff member who observed unbagged respiratory items should notify a nurse. The Administrator stated that nurses or aides were responsible for bagging the items and reported that there was no existing facility policy regarding storage of respiratory items when not in use.
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