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Introduction to Surveying for Non-Long Term Care Case Study Page 1 of 2 Introduction to Surveying for Non-Long Term Care Case Study Scenario November 11, 2010 at 3:38 PM The surveyor observes a woman who has approached the nurse’s station. The woman states, “My husband’s monitor says that his oxygen level is 74 percent. Can someone come in and take a look at him?” A nurse enters the patient’s room and is overheard explaining that the fingertip pulse oximeter had partly fallen off the patient’s finger and that was the reason for the low reading. The nurse informs the family that room equipment is monitored at the nurse’s station. Should any abnormalities register on a patient, an alarm will sound at the station. After explaining this to the family, the nurse exits the room. The surveyor enters the patient’s room, introduces herself, and explains her purpose for observing the hospital. She asks the patient if he is comfortable and would he mind if she asks a few questions. The surveyor notices that, according to the monitor, the patient’s oxygen saturation is still low at 83 percent. The surveyor mentions that she overheard the wife asking a nurse for help because the level was at 74 percent. The wife says that the nurse informed them that the machine was not properly placed on the patient’s finger. The surveyor asks the patient if he feels short of breath and he answers yes. The surveyor excuses herself from the patient’s room and asks the nurse to please check on the patient, as he is short of breath. The surveyor asks another nurse at the station if any of their alarm systems have signaled. The nurse answers no. Upon surveyor request, the nurse reviews the alarm parameters and settings. The screen indicates that the alarm is on, set at 90 percent, and the sound is enabled. The nurse remarks to the surveyor, “This system is driving me crazy–sometimes it works and sometimes it doesn’t–we’re supposed to be getting a new system in a few months so we’re making do with this one right now.”

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Page 1: Introduction to Surveying for Non-Long Term Care … · Introduction to Surveying for Non-Long Term Care Case Study Page 2 of 2 Appendix A of the State Operations Manual 42 CFR §482.41(c)(2)

Introduction to Surveying for Non-Long Term Care Case Study Page 1 of 2

Introduction to Surveying for Non-Long Term Care Case Study Scenario November 11, 2010 at 3:38 PM The surveyor observes a woman who has approached the nurse’s station. The woman states, “My husband’s monitor says that his oxygen level is 74 percent. Can someone come in and take a look at him?”

A nurse enters the patient’s room and is overheard explaining that the fingertip pulse oximeter had partly fallen off the patient’s finger and that was the reason for the low reading. The nurse informs the family that room equipment is monitored at the nurse’s station. Should any abnormalities register on a patient, an alarm will sound at the station. After explaining this to the family, the nurse exits the room.

The surveyor enters the patient’s room, introduces herself, and explains her purpose for observing the hospital. She asks the patient if he is comfortable and would he mind if she asks a few questions. The surveyor notices that, according to the monitor, the patient’s oxygen saturation is still low at 83 percent.

The surveyor mentions that she overheard the wife asking a nurse for help because the level was at 74 percent. The wife says that the nurse informed them that the machine was not properly placed on the patient’s finger. The surveyor asks the patient if he feels short of breath and he answers yes.

The surveyor excuses herself from the patient’s room and asks the nurse to please check on the patient, as he is short of breath. The surveyor asks another nurse at the station if any of their alarm systems have signaled. The nurse answers no.

Upon surveyor request, the nurse reviews the alarm parameters and settings. The screen indicates that the alarm is on, set at 90 percent, and the sound is enabled. The nurse remarks to the surveyor, “This system is driving me crazy–sometimes it works and sometimes it doesn’t–we’re supposed to be getting a new system in a few months so we’re making do with this one right now.”

Page 2: Introduction to Surveying for Non-Long Term Care … · Introduction to Surveying for Non-Long Term Care Case Study Page 2 of 2 Appendix A of the State Operations Manual 42 CFR §482.41(c)(2)

Introduction to Surveying for Non-Long Term Care Case Study Page 2 of 2

Appendix A of the State Operations Manual 42 CFR §482.41(c)(2)

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Regulation Language

Guidelines

A-0724

§482.41(c)(2) Facilities, supplies, and equipment must be maintained to ensure an acceptable level of safety and quality.

Equipment includes both facility equipment (e.g., elevators, generators, air handlers, medical gas systems, air compressors and vacuum systems, etc.) and medical equipment (e.g., biomedical equipment, radiological equipment, patient beds, stretchers, IV infusion equipment, ventilators, laboratory equipment, etc.). There must be a regular periodical maintenance and testing program for medical devices and equipment. A qualified individual such as a clinical or biomedical engineer or other qualified maintenance person must monitor, test, calibrate and maintain the equipment periodically in accordance with the manufacturer’s recommendations and Federal and State laws and regulations. Survey Procedures:

Interview the person in charge of medical equipment and determine if there is an adequate repair/periodical maintenance program.

Verify that all medical devices and equipments are routinely checked by a clinical or biomedical engineer.

Review maintenance logs for significant medical equipment (e.g., cardiac monitors, IV infusion pumps, ventilators, etc.).

Are supplies maintained in such a manner as to ensure that safety?

Are supplies stored as recommended by the manufacturer?

Are supplies stored in such a manner as to endanger patient safety?

Has the hospital identified supplies and equipment that are likely to be needed in emergency situations?

Has the hospital made adequate provisions to ensure the availability of those supplies and equipment when needed?