IDPH has cited and fined Elevate Care nursing home in Waukegan after a resident there suffered third degree burns in a smoking accident.
Nursing home residents are adults, and as adults they still have the right to engage in certain habits that are not good for their health, and smoking is one of them. In a nursing home setting, there are two specific risks associated with smoking that are not generally present in the community at large. Like any risk to the health and well-being, the risks associated with smoking must be addressed in the resident care plan.
The first of these risks is the risk of flash fires associated with the use of compressed oxygen equipment. The second of these are burns and fires occurring due to residents dropping or mishandling cigarettes and other smoking materials due to shaking of the hands or weakness often associated with neurological or muscular disorders. Similar to nursing home falls, the likelihood of having an adverse event is multiplied when the resident suffers from dementia, confusion, or otherwise shows poor judgment for their own safety.
In most nursing homes, there is an outdoor area designated for smoking and set times when the residents are allowed out to smoke under the supervision of staff. Residents who demonstrate noncompliance with smoking safety practices must have this behavior addressed in the resident care plan.
In this situation, the resident suffered from chronic obstructive pulmonary disease (COPD) and dependent on supplemental oxygen. On the day of this nursing home smoking accident, the resident went out onto the smoking deck unattended before the time that was designated for smoking. The staff was aware that he had done so multiple times before this, but this behavior was not addressed in the resident care plan.
The fire occurred as the resident was lighting cigarette butts without shutting off his supplemental oxygen. The flash fire from the ignition of the supplemental oxygen caused first, second, and third degree burns to his face, eyes, and nostrils. He was taken to the hospital for treatment of his burns.
After the fire occurred, the nursing home placed locks on the door to the smoking deck to prevent unsupervised resident access to that area.
This was an accident which should have been easily prevented: limiting access to the smoking deck during hours when staff is not present and taking away smoking materials such as a lighter from the resident when unsupervised. Unfortunately, it too often takes a serious accident such as this to spur a nursing home to take the steps necessary to prevent accident injury to residents.
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