Question

Instructions:   Please read the following observations from a Department of Health Survey and identify noncompliance.  Identify the Ftag that is associated with the noncompliance and put a plan of correction for the organization to put in place to be in compliance in the future.  Remember to follow the format for assignment submission and include references.

Assignment 2 scenario.

A resident (diagnosed with Parkinson’s Disease; COPD; listed as assist of two in his care plan; and had experienced two falls in last six months) fell from a recliner lounge chair to the floor in the residents’ common area of the nursing home around 7:30 PM, when he stood and attempted to walk without assistance.  According to the nurse he did not identify shortening of the right leg or external rotation when he assessed the resident immediately after the fall.  The resident did complain of right groin pain when he fell, during the remainder of the evening and through the night.  The nurse did not evaluate the resident for a possible fracture again after the initial assessment when the fall occurred, despite complaints of ongoing paid in the right groin.   The resident’s primary physician was notified of the fall by fax at 7:31am the next morning.  A second fax indicates that the physician contacted nursing administration at 8:15 am following the second fax.  Physician requested an assessment by nursing administration and report back to him. Nursing Administration identified in their assessment resident has shortening of his right leg and was unable to bear weight.  Resident was sent by ambulance at 9:15 am the morning following the fall to the emergency room at regional medical center.  Nursing home has policy and procedure that directs staff to inform the resident’s physician immediately of a significant change, a need to alter treatment significantly or a decision to transfer.  

Further investigation showed that two other residents had falls with concerns for the assessment of falls risk and interventions.  

A second Resident with a history of falls experienced a fall earlier in the week from her wheelchair as she was attempting to self-transfer to bed.  She sustained a bruise on her forehead.  Her physician and family were notified and the resident as treated and observed by nursing staff.  There is no documentation to support an assessment after this fall or new interventions attempted.  The resident fell again in 5 days from her wheelchair sustaining bruising on her forehead.  Following the second fall, an assessment was done and a change in intervention was implemented.

The third resident diagnosed with Alzheimer’s Dementia, had a history of falls.  After further review of this resident, the resident had an alarm on, fell to the floor before staff could reach him.  He had minor cuts from this fall.  There was no documentation of an assessment of the fall and possible change in interventions noted that might reduce the risk of future falls

Answer 1

Ftag for non compliance due to fall is Ftag-689. The scenario shows that in this organization there is no proper protocol for risk assessment and accident prevention. PLAN OF ACTION 1)organization should have a written policy about how to take care of elderly with different problems like alzheimer's, parkinson's ect. 2) Nursing staff should be well aware of the policies, follow them and trained to take care of these type of cases. 3) Elderly person should never be left alone. 4) Nursing staff should have a good observation power and knowledge to perform physical assessment, and always inform concerned doctor about any changes. 5)Always maintain an incident report with clear information about incident, observation made, and what intervention done, what preventive measures taken for such cases, so it is easy to review and revise the policies depednds on it. 6)The organization needs to provide safe environment, adequate supervision and assistance. Reference : 1) https://www.licamedman.com>ftag 2) https://www.medicalmutual.com>tip