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Nursing Home Fails to Maintain and Follow Status Codes

In the context of healthcare, hospitals commonly use a code status to indicate a patient’s condition, particularly during an incident or event. A code status also indicates what types of procedures or protocols can be used or followed to treat a patient depending on the type of event they are experiencing, such as a heart attack or a collapsed lung. This could include using electric shock paddles to get a heartbeat going again, possibly chest compressions for the same, injecting a certain drug to stimulate a part of the body, or possibly intubation to provide oxygen to the lungs.

The worst code status phrases that some may be aware of include “Do Not Intubate,” and “Do Not Resuscitate,” which likely means there is nothing more to be done for the patient. Those who have had experiences themselves or with loved ones in hospitals may unfortunately be familiar with these terms, as might fans of medical dramas on television. It is crucial that code status be well understood and carefully communicated, otherwise the wrong procedure could be performed and result in further injury, death, and the inevitable medical malpractice claim. Patients will also typically have the opportunity to convey what they want done in certain situations ahead of time, and unless they are incapacitated or unconscious, can change their minds at any point. For example, they may choose not to be resuscitated in certain scenarios.

The Nursing Home Issue

Code status can also be used in nursing homes. At the Pioneer Care nursing home facility in Minnesota, the nursing staff uses “cheat sheets” for each resident that indicate what procedure to use in certain circumstances. The nursing home has been accused of negligence in the death of one of its residents. According to a report, two practicing nurses at the facility did not perform cardiopulmonary resuscitation (CPR) on the patient, and minutes later he died. One of the nurses indicated that she did not check the patient’s personnel code status sheet to see what protocol was preferred.

Making things worse, the state Health Department found that the “cheat sheet” for this particular patient, which stated the patient preferred not to be resuscitated, was in fact inaccurate. The patient’s consent form sated a preference for resuscitation, but the cheat sheet failed to reflect this. So even if the nurse simply forgot to check, the staff would have made the wrong decision anyway.

The facility is defending itself against the charge for neglect because the cheat sheet “did not play any role” in the nurses’ not attempting to resuscitate the patient. The facility did make efforts to re-train the staff after this incident, and according to a report has been up to code. The incident is nevertheless a wake-up call for nursing homes to ensure that all protocols are in place and accurate, and that patients’ status code preferences are followed carefully. Simple administrative mistakes could mean the end of someone’s life. Facilities and staffers must ensure that these codes are written up and checked with tremendous care.

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