| 58 |
BOYINGTON HEALTH AND REHABILITATION |
255092 |
1530 BROAD AVE |
GULFPORT |
MS |
39501 |
2017-05-18 |
441 |
E |
1 |
0 |
UDH111 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, record review, staff interview and facility policy review, the facility failed to maintain and monitor infection tracking for three (3) of six (6) sampled residents with isolation procedures and two (2) of eight (8) Unsampled residents with isolation procedures, Residents #1, #7, and #11 and Unsampled Residents #B and #C; for five (5) of eight (8) residents. Findings include: Review of the facility policy entitled, Infection Control Policies/Practices, dated 08/14, revealed, Policy Interpretation and Implementation, 2. d. Maintain records of incidents and corrective actions related to infections. Resident #1: Review of the Care Plan for Resident #1 revealed [MEDICATION NAME] Cream for Scabies had been initiated/administered to the Resident on 04/04/17. Review of the Monthly Infection Control Report revealed there was no entry for Scabies for the month of (MONTH) (YEAR). There was one (1) entry for Resident #1, on 04/13/17, for Symptoms -itching with an order for [REDACTED]. There was no Site, Care Plan or Date Resolved documented on the Infection Control Report. There was no indication as to why itching would have been included on the log as an infection. Interview with the Infection Control Registered Nurse (RN), on 05/12/17 at 1:10 PM, revealed she was responsible for the Monthly Infection Control Report as well as having tracked and trended infections in the facility. The Infection Control RN stated the Scabies had not been recorded on the Infection Control Report for Resident #1 because an antibiotic was not given. She also stated in hind sight she should have included the Scabies on the Infection Control Report. Review of the Admission Record revealed the facility admitted Resident #1 on 02/25/17, with diagnoses, which included Cerebral Infarction and [DIAGNOSES REDACTED]. Review of the 14 day Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 03/10/17, revealed the Resident scored 13 of 15 on the Brief Interview for Mental Status (BIMS,) which indicated he was cognitively intact. Resident #7: Observation of Resident #7, on 05/11/17 at 2:35 PM, revealed there were isolation supplies on the door of his room. Review of Resident #7's clinical record revealed there had been no order for isolation written. There was an order for [REDACTED]. Interview, on 05/11/17 at 2:35 PM, with RN #1 revealed he thought Resident #7 had been in isolation due to ESBL (Extended-Spectrum B-Lactamases) in his urine, but he was unable to locate an order for [REDACTED].#1 also stated the isolation was implemented after an order was written for [MEDICATION NAME]. Review of the Admission Record revealed the facility readmitted Resident #7 on 12/22/16, with diagnoses, which included Type 2 Diabetes Mellitus and Morbid Obesity. Review of the quarterly MDS, with an ARD of 03/18/17, revealed he scored 9 of 15 on the BIMS which indicated he had moderate cognitive impairment. Resident #11 Observation on 05/10/17 at 11:30 AM, revealed there were isolation supplies on the door of Resident #11's room. Review of the cumulative Order Summary Report for Physician's Orders for 05/17, revealed an order dated 03/14/17, for Contact Isolation for MRSA (Methicillin-Resistant Staphylococcus Aureus). Further review of the Physician's Orders revealed Resident #11 did not have a current order for an antibiotic. Review of Resident 11's roommate's chart (Unsampled G) revealed there was no order for isolation. Interview, on 05/12/17 at 11:25 AM, with the interim Director of Nurses (DON) confirmed the antibiotics for Resident #11 were ordered on [DATE], for five (5) days, and the isolation was never discontinued, and she was unable to provide an explanation as to why the isolation was never discontinued. Review of the Admission Record revealed the facility admitted Resident #11 on 08/22/16, with diagnoses, which included Dementia and [DIAGNOSES REDACTED]. Review of the quarterly MDS, with an ARD of 02/23/17, revealed he scored 3 of 15 on the BIMS, which indicated he had severely impaired decision making abilities. Unsampled Resident B Observation, on 05/10/17 at 11:30 AM, revealed there were isolation supplies on Unsampled Resident B's door. Review of Unsampled Resident B's cumulative Order Summary Report of Physician's Orders for 05/17, revealed an order, dated 03/17/17, for Contact Isolation for MRSA in L (left) hip wound. The only current antibiotic order for Unsampled Resident B was [MEDICATION NAME] for a sinus infection, which did not include an isolation order. Review of a handwritten order, dated 04/11/17, revealed an order to D/C (discontinue) all wound orders. Interview on 05/11/17 at 3:10 PM, with Licensed Practical Nurse (LPN) #1, revealed Unsampled Resident B had been on the antibiotic [MEDICATION NAME] for 14 days on the 03/17/17 order. LPN #1 also stated the isolation order was probably not discontinued when the wound orders were discontinued. LPN #1 stated the nurses work with the Infection Control RN to discontinue isolation when appropriate. Review of the Admission Record revealed the facility admitted Unsampled Resident B on 10/04/16, with diagnoses, which included Pressure Ulcer of Sacrum and Type two (2) Diabetes Mellitus. Review of the quarterly MDS, with an ARD of 03/30/17, revealed she scored 15 on 15 on the BIMS, which indicated she was cognitively intact. Unsampled Resident C Observation, on 05/10/17 at 11:30 AM, revealed Unsampled Resident C had isolation supplies on the door of the room. Review of Unsampled Resident C's cumulative Order Summary Report for 05/17, revealed an order, dated 03/17/17 for Contact Isolation for VRE ([MEDICATION NAME] Resistant [MEDICATION NAME]) in Wound. There was an order, dated 05/11/17, for the antibiotic [MEDICATION NAME] for Leukocytosis (elevated [NAME] Blood Cell level, which indicated a possible infection). Interview with LPN #1, on 05/11/17 at 3:30 PM, revealed Unsampled Resident C had been placed on antibiotics for 14 days on 03/17/17, due to a wound infection with an order for [REDACTED].#1 also stated the Resident had been started on an antibiotic on 05/11/17, due to a Urinary Tract Infection, but no order or need for isolation. LPN #1 stated she did not know why the isolation had not been discontinued after the antibiotic treatment to the wound was discontinued. Review of the Admission Record revealed the facility readmitted Unsampled Resident C on 08/06/16, with diagnoses, which included Chronic Obstructive Pulmonary Disease and Urinary Tract Infection. Review of the quarterly MDS, with an ARD of 02/04/17, revealed the Resident scored 15 of 15 on the BIMS which indicated he was cognitively intact. |
2020-09-01 |