| 33 |
EASTVIEW REHABILITATION & HEALTHCARE CENTER |
15014 |
7755 FOURTH AVENUE SOUTH |
BIRMINGHAM |
AL |
35206 |
2018-01-25 |
688 |
D |
0 |
1 |
I9JH11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, review of Physician order's, review of Fundamentals of Nursing and staff interview the facility failed to ensure Resident Identifier (RI) #32's hand splints were in place to prevent decreased ROM. This deficient practice was observed on three of four days of the survey for one of one residents sampled for rehabilitation and restorative. Findings Include: A review of Potter and Perry Fundamentals of Nursing with a copyright of (YEAR) Chapter 28 Immobility page 408 and 414 documented: . Nurses intervene to maintain maximum Range of Motion (ROM) in unaffected joints and . collaborate with physical therapists to design interventions to strengthen affected muscles and joints . Fingers and Thumb. The ROM in the fingers and thumb enables a patient to perform Activities of Daily Living (ADLs) and activities requiring fine-motor skills . Resident Identifier (RI) #32 was readmitted to the facility on [DATE] with [DIAGNOSES REDACTED]. A review of RI #32's annual Minimum Data Set (MDS) with an Assessment Reference Date of 01/01/2018 revealed RI #32's Brief Interview for Mental Status (BIMS) score of 15, indicating intact. cognition. Section G of the MDS, for Functional Status documented RI #32 was totally dependent on staff for all activities of daily living (ADL) and Range of Motion (ROM) upper extremity impairment on both sides. A review of RI #32's (MONTH) (YEAR) Physician order [REDACTED]. On 01/24/2018 at 10:05 AM, RI #32's call button was observed secured to his/her gown. RI #32 was asked if he/she could push the call button. RI #32 responded he/she could not push the call button and he/she did not know he/she had one. RI #32 attempted to push the call button but could not due to bilateral contractures to hands. Bilateral hands observed with no palm guards. On 01/24/2018 at 12:30 PM, RI #32 was observed without palm guards in bilateral hands. On 01/25/2018 03:30 PM, the surveyor and Employee Identifier (EI) #3 Registered Nurse (RN)/Unit Manager went to RI #32's room assess hands. EI #3 attempted to open the fingers on bilateral hands with no success. EI #3 was asked if there were palm guards in RI #32's hands bilaterally. EI #32 said, no. On 01/25/2018 at 02:56 PM, an interview was conducted with EI #32. EI #32 was asked what did the (MONTH) Physician order [REDACTED]. EI #3 said, to have the palm guards to bilateral hands. EI #3 was asked why should RI #32 have the palm guards. EI #3 said, for contracture management. EI #3 was asked who was responsible to ensure RI #32 had the palm guards per Physician order. EI #3 said, the nurse. EI #3 was asked if the Physician order [REDACTED].#3 said, no. On 01/25/2018 at 03:00 PM, EI #3 went to RI #32's room with the surveyor. EI #3 asked RI #32 to push the call button. RI #32 was unable to push the call button due to hands being contracted. EI #3 was asked how did RI #32 make the staff aware when he/she needed something. EI #3 said, RI #32 would call out or the roommate would let someone know. EI #3 said, I should have gotten RI #32 another type of call button that he/she could use. EI #3 was asked why could RI #32 not push the call button. EI #3 said, because of the hand contractures. EI #3 asked what was the potential harm in RI #32 not being able to push the call button. EI #3 said, puts RI #32 at risk for aspiration and danger. Position, Mobility 01/24/2018 10:01 AM, RI #32' bilateral hands observed with fingers clinched and closed. RI #32 was asked to open his/her hands and said, I can not open them. A review of RI #32's (MONTH) (YEAR) Physician orders [REDACTED]. RI #32 was observed lying supine with no palm guards on to bilateral hands. 01/24/2018 12:30 PM, resident observed in supine position. 01/24/2018 03:00 PM, resident observed in same supine position. 01/25/18 14 03:00 PM, an interview was conducted with EI #3, RN/Unit Manager. EI #3 was asked did RI #32 have any pressure ulcers. EI #3 said, No. EI #3 was asked if RI #32 was at risk for developing pressure ulcers. EI #3 said, yes. EI #3 was asked how often was RI #32 to be turned. EI #3 said, every two hours because RI #32 was at risk for pressure ulcers. EI #3 was asked who was responsible to ensure RI #32 was turned. EI #3 said, the CNA and nurses. EI #3 was asked could RI #32 turn or reposition his/herself. EI #3 said, no. EI #3 was asked what is the potential harm in not turning and repositioning RI #32. EI #3 said, the potential for developing a pressure ulcer. |
2020-09-01 |