IDPH has cited and fined Swansea Rehabilitation & Health Care Center nursing home after a resident there suffered a fractured hip in a fall after she was left unattended while going to the bathroom.
The resident at issue was recognized as being at risk for falls. She suffered from cognitive impairments, was not steady on her feet and only able to stabilize with staff assistance while walking. This combination of physical and cognitive impairments is a leading indicator of fall risk because they are not able to walk safely, but at the same time cannot be counted on to follow instructions or make good decisions for their own safety.
Due to her fall risk, a fall prevention care plan was put into place. The fall prevention measures included one person assist with use of a gait belt for all ambulation.
On the day of this nursing home fall, the resident was brought to the bathroom by an aide to use the toilet before dinner. While the resident was using the toilet, the aide left the resident to get a washcloth. When she returned, she found the resident in a seated position on the floor of her room. The aide admitted to the state surveyor that she knew that she should not have left the resident alone on the toilet. She also admitted to the state surveyor that she told the nurse on duty that she was in the room when the resident fell when actually was not because she did not want to get into trouble.
The aide reported the fall to the nurse who in turn notified the resident’s physician. The doctor ordered x-rays which showed that there was an acute fracture of the hip. The resident was then sent to the hospital for further care.
The cause of this fall and injury to the resident is readily apparent – the aide admitted that the resident should not have been left unattended while on toilet, but she was. The aide told the surveyor that she thought she would be gone for 30 seconds, but it was clearly longer than that, given that the resident finished going to the bathroom, got up from the toilet, and walked into her room where the fall occurred. More troubling than this is the fact that the aide lied to the nurse about what happened, which raises questions as to exactly what was really being done to care for this resident.
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