A resident at the Shawnee Christian Nursing Center in Herrin, Illinois suffered a broken nose after a nursing home fall. What makes this nursing home fall different from most is the circumstances that lead to the injury.
In December of last year, one of the nurses at the Shawnee Christian Nursing Center claims to have requested a change in the time a medication was given to one of the residents living at the facility.
Instead of simply changing the time the medication was to be administered, the physician increased the dosage. One of the registered nurses at the facility stated to nursing home investigators that “we asked the doctor to change the time of his medication. I think he thought that we were needing something to help him sleep. I don’t know if in the shuffle of all the patients we had to see that day, there was just a miscommunication.”
And yet, the nursing home did no follow up with the physician to verify the “miscommunication.” Nor did they make any effort to carefully monitor the resident for signs that the increase in medication was having a detrimental effect.
After the nursing home fall, the facility conducted the required investigation and determined that the increase of medication was the cause of the nursing home fall.
While the nursing home staff seems to be attempting to push the blame for the injury on the resident’s physician, there are several reasons why the culpability rests on the facility.
First, the nursing home was the entity requesting a change in the status quo. Therefore, when the physician responded for a change in medication timing with an unrelated increase in medication, it was incumbent upon the facility to follow up on this discrepancy.
In addition, after any change in medication or behavior, nursing home staff need to exercise increased vigilance to determine if there is an increased likelihood of injury. When there is a negative change in a resident’s condition following a change in medication regimen, the nursing staff must notify the doctor. In this case, the nursing home stated that there were no notes made in the man’s behavioral charts.
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