| 45 |
PLANTATION MANOR NURSING HOME |
15015 |
6450 OLD TUSCALOOSA HIGHWAY P O BOX 97 |
MC CALLA |
AL |
35111 |
2019-05-02 |
695 |
D |
0 |
1 |
X13O11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and facility policies titled, Oxygen Concentrator and Oxygen Administration, facility failed to ensure Resident #54's nasal cannula tubing was labeled with a date and the tubing connecting the concentrator with the water bottle were not out of date. This had a potential to affect of one of three residents observed receiving oxygen therapy. Findings include: A review of the facility's policy titled, OXYGEN CONCENTRATOR, with no effective date, revealed: . Policy Explanation and Compliance Guidelines: 5. Care of the Concentrator . c. i. Change oxygen tubing and mask/cannula weekly and as needed if it becomes soiled or contaminated. .iii. If applicable, change nebulizer tubing and delivery devices every seventy-two hours. A review of the facility titled, Oxygen Administration, with no effective date, revealed: . Policy Explanation and Compliance Guidelines: . 5. d. If applicable, change nebulizer tubing and delivery devices every 72 hours and as needed if they become soiled or contaminated . RI# 54 was admitted to facility on 10/13/17 and readmitted on [DATE] with [DIAGNOSES REDACTED].>[MEDICAL CONDITION], acute and chronic [MEDICAL CONDITION] with hypercapnia, acute and chronic [MEDICAL CONDITION] with [MEDICAL CONDITION], and obstructive sleep apnea. On 04/30/19 at 09:56 am, the Surveyor observed Resident # 54 with oxygen, per nasal cannula, with no date on the nasal cannula tubing. The tubing connecting the concentrator and water bottle, dated 2/11/19, was handwritten on the tubing. The water bottle was dated 4/26/19. On 04/30/19 at 12:04 pm, the Surveyor observed Resident # 54 with oxygen per nasal cannula, with no date on the cannula tubing and a date of 2/11/19 was handwritten on the tubing connecting the concentrator and the water bottle. On 05/01/19 at 04:19 pm, the Surveyor observed Resident # 54 with oxygen in use by nasal cannula. No date was written on the nasal cannula tubing or the tubing connecting the concentrator with the water bottle. The water bottle was dated 5/1/19. On 05/02/19 01:18 PM, the Surveyor interviewed the Director of Nursing Employee Identifier (EI) #1. The Surveyor asked how often was the nasal cannula tubing and concentrator tubing changed. EI #1 replied, once a week. The Surveyor asked did they have a place to document the tubing changes. EI #1 replied, no. It should be written on the tubing. The Surveyor asked, if there was oxygen tubing that was dated for (MONTH) 11, 2019, handwritten, what would that date represent. EI#1 replied, that would be the date that it was changed. The Surveyor asked, if the oxygen tubing was dated (MONTH) 11, 2019, and was observed on 4/30/19, would that be considered correct, per facility policy. EI #1 replied, no it would not. The Surveyor asked, what specific tubing was changed weekly. EI #1 replied, the nasal cannula. The tubing connecting the concentrator to the water bottle was changed every three to four days. The Surveyor asked, was it a requirement of the staff to hand write the date of change on the tubing. EI #1 replied, yes. The Surveyor asked, how did they know if the tubing had been changed. EI #1 replied, by the date written on the tube. The Surveyor asked, what was the potential harm in not changing the oxygen tubing. EI #1 replied, infection. |
2020-09-01 |