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Management of rest home resident suffering from dehydration; communication with welfare guardian (08HDC20829)

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(08HDC20829, 18 January 2010)

Aged care facility ~ Nurse manager ~ Registered nurse ~ Standard of care ~ Communication ~ Documentation ~ Dehydration ~ Deterioration ~ Welfare guardian ~ Non-compliance with policies ~ Rights 4(1), 4(2), 4(3), 6(1), 6(3)

The family of an elderly woman complained about the care she received while a resident of a rest home facility to which she had been transferred from hospital.

At the time of discharge from hospital, clear instructions were provided in the discharge summary in relation to the patient's current need for active hydration management. This plan was reiterated by the GP following his initial assessment. However, this prescribed management plan was not followed by nursing staff, and the patient deteriorated. Despite her daughter and friend both raising concerns with nursing staff about the patient's evident deterioration, a medical assessment was not requested. The patient continued to deteriorate rapidly and was eventually referred back to hospital. However, she did not recover and died a short time later.

It was held that the facility did not provide an adequate standard of care consistent with the patient's needs and in line with the facility's policies, and it did not maintain adequate documentation and obtain medical intervention in a timely manner. The facility breached Rights 4(1), (2) and (3). It also failed to provide the patient's welfare guardian with adequate updates, in breach of Right 6(1).

The nurse manager, who had overall responsibility for managing care staff and ensuring that residents were provided with an adequate standard of care and adequate documentation maintained, was found in breach of Rights 4(1), (2) and (3). For failing to ensure adequate communication, and accurate information to the welfare guardian, the nurse manager was found in breach of Rights 6(1) and 6(3).