IDPH has cited and fined Pekin Manor nursing home after a resident there had to be hospitalized with respiratory failure due to the failure of the staff to order necessary medical equipment.
The resident at issue was admitted to the nursing home with orders from his doctor to have his chest tube drained daily until draining the chest tube returned less than 100 cc’s of fluid, at which point the frequency with which the chest tube had to be drained less frequently. On Wednesday, February 27, the nurses treating this resident recognized that they were running low on the bottlesg necessary to drain the chest tube. A request was made internally at the nursing for an order to be placed, but the order was never placed. By Friday, March 1, they were down to the last bottle, so a request was made to have the supplies delivered on a 24-hour basis. However, the medical equipment supplier did not made 24-hour deliveries on weekends, so the resident did not get the chest tube drained over the weekend.
The resident was taken to the emergency room Sunday night suffering from respiratory failure. When he was in the emergency room, the doctors there drained 800 cc of fluid from the resident’s chest. The resident was admitted to the hospital.
One of the basic tasks that nursing homes are charged with are carrying out physician orders. In this case, that included doing daily drainage of the chest tube. In order to do that, the necessary supplies had to be on hand.
Nursing homes are businesses, and well-run businesses have systems in place to deliver the basic services that are supposed to be provided. In the nursing home setting that means having systems in place to ensure that supplies are on hand to deliver the care that the residents need. Here there was a system that simply failed: the supplies that were needed were not ordered. As a resulty, the nursing home failed to provide necessary care.
However, once the staff was aware that there were not going to be supplies on hand to provide the resident with the care that the doctor ordered, simply skipping it and hoping for the best was not a real option. This was a situation where physician notification was required, as it was not the nurse’s role to decide whether it would be okay for the resident to go without the care that was needed.
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