cms_RI: 69
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 69 | OAK HILL HEALTH & REHABILITATION CENTER | 415027 | 544 PLEASANT STREET | PAWTUCKET | RI | 2860 | 2017-06-30 | 281 | E | 1 | 0 | 1II511 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review, surveyor observations, and staff interviews, it has been determined that the facility failed to provide services which meet professional standards of quality for 4 of 16 sample residents (ID#s 3, 5, 13, and 15) relative to clarifying physician's orders [REDACTED]. Findings are as follows: According to Basic Nursing, Mosby, 3rd Edition, The registered nurse checks all transcribed orders against the original order for accuracy and thoroughness. If an order seems incorrect or inappropriate, the nurse consults the physician . The following orders were found to be incomplete and requiring clarification from the physician: 1.) Record review for resident ID #3 revealed the following physician orders: -Current order dated 2/23/2017 for [MEDICATION NAME] Tablet 325 mg, give 2 tablets by mouth every 4 hours as needed for pain. -Current order dated 4/18/2017 for [MEDICATION NAME] (Concentrate) Solution 20 mg/ml, give 5 mg by mouth every 4 hours as needed for pain. The above orders do not include parameters stating the conditions under which each medication should be administered, leaving it unclear as to which to administer when the resident is experiencing pain. Further record review for resident ID #3 revealed the following physician orders: -Current order dated 2/28/2017 for [MEDICATION NAME] Solution 1%, give 2 drops by mouth every 2 hours as needed for secretions. -Current order dated 2/28/2017 for [MEDICATION NAME] Solution 1%, give 4 drops by mouth every 2 hours as needed for secretions. The above orders do not include directions indicating which to administer when the resident is experiencing secretions. 2.) Record review for resident ID #5 revealed the following physician orders: -Current order dated 5/14/2017 for Tylenol, give 2 tabs by mouth (PO) every six hours as needed for pain. -Current order dated 6/2/2017 for [MEDICATION NAME], give 0.25 mg every four hours as needed for pain or dyspnea. The above orders do not include parameters stating the conditions under which each medication should be administered, leaving it unclear as to which to administer when the resident is experiencing pain. 3.) Record review for resident ID #13 revealed a current physician order [REDACTED]. Review of the physician's orders [REDACTED]. 4.) Closed record review for resident ID #15 revealed the following physician orders: -Order dated 3/22/2017 for [MEDICATION NAME], give 5 mg as needed for a pain scale of 1-5. -Order dated 3/21/2017 for [MEDICATION NAME], give 7.5 mg as needed for moderate to severe pain. These orders utilize different pain scales. Review of the facility's policy and procedure for pain assessment revealed a Pain Assessment in Advanced Dementia Scale indicating moderate pain as 4 to 6 and severe pain as 7 to 10. Further review of the policy revealed a numeric pain scale with zero indicating no pain and 10 indicating the worst pain. These two scales overlap which makes it unclear which scale to utilize when administering pain medication. During surveyor interview with the Director of Nursing (DON) on 6/30/2017 at 11:30 AM, she could not provide evidence that the facility had consulted with the physician to clarify the above orders. | 2020-09-01 |