| 97 |
GUAM MEMORIAL HOSPITAL AUTHORITY |
655000 |
499 NORTH SABANA DRIVE |
BARRIGADA |
GU |
96913 |
2010-09-17 |
241 |
E |
0 |
1 |
7DPX11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and record review, the facility did not promote care for residents in a manner and in an environment that maintained or enhanced the resident ' s dignity and self-respect. Findings include: 1. During the survey, bed-bound residents were repeatedly heard calling out to staff for assistance before receiving a response. In several instances, staff had to be summoned to the resident's room to ensure that the resident received assistance. For example: a. Resident 3 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Review of the medical record revealed that the resident was admitted from the hospital where she was treated for [REDACTED]. The minimum data set ((MDS) dated [DATE] described the resident as having short-term memory problem, with moderately impaired cognitive skills for decision-making, and was dependent on staff for all activities of daily living (ADL). Throughout the survey, Resident 3 was frequently heard calling out to staff for assistance to get out of bed or to the bathroom. On 9/15/10 at 1:30 p.m. for example, the resident was heard from the hallway calling out "nurse ...nurse" repeatedly. When asked what she wanted, the resident replied, "Help me up ...help me up. I want to go to the bathroom." At 3:30 p.m. on 9/15/10, Resident 3 was again observed calling out, "get me up ...I want to get up." At 10:35 a.m. on 9/16/10, the resident was heard, saying repeatedly, "I want to get up ...I want to get up." When asked what she wanted to do, the resident replied that she wanted to get out of bed. When asked if Resident 3 could get out of bed, a facility staff interviewed stated that she did not know. b. Resident 7 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Nursing admission notes dated 9/05/10 described Resident 7 as "alert and oriented (times) 2;" that she was "verbally responsive but confused;" and that she was incontinent of bowel and bladder function and was "using adult diaper." Review of additional nurses notes indicated that Resident 7 had behaviors of calling out including on 9/05/10 when she was described "calling her sister mama;" on 9/12/10, when she was noted as "confused at times" and "calling names;" on 9/14/10 with "on and off shouting;" and on 9/16/19 when she was described as "kept on yelling asking for help." During the initial tour at 9:55 a.m. on 9/15/10, Resident 7 was heard from outside her door repeatedly calling out to staff for assistance. When asked what she wanted, the resident replied, "I want to change my pampers. It's wet." The resident continued to state, "Please, please, ask the girls." When this was brought to attention, a facility staff on the tour with the surveyor summoned a CNA (certified nurse aide) who thereafter attended to the resident's needs. During the survey, Resident 7 was heard calling out several more times and in all these, staff were not observed to promptly check on the resident to determine the reasons for calling out. On 9/16/10 at 9:05 a.m., for example, Resident 7 was heard calling out, "I want to turn, I want to turn." At 3:05 p.m. on 9/16/10, Resident 7 was heard calling out, "I want to get up, I want to get up." When asked what she wanted, the resident stated that she wanted "to move." When asked if she knew to use the call light for assistance, the resident did not reply. When approached, the staff stated that the resident was confused and that sometimes she does not know what she wants. 2. During the group interview on 9/16/10, several residents complained about the slow response from facility staff regarding summons made for assistance. In the same meeting, three residents complained that staff were slow to respond to call lights especially on the night shift. One patient indicated that the facility needed more staff to attend to patients' needs at night. Also the slow response to residents' calls for assistance occur during early morning when residents needed to use the restroom. (Cross-refer to F241.) |
2014-12-01 |