ST MARY MEDICAL CENTER

Report ID: N7CW11, California Department of Public Health

Reported Entity: ST MARY MEDICAL CENTER

Issue:

Based on observation, interview and document review, the hospital failed to ensure that 1 of 47 sampled patients (Patient 64) had the right to personal privacy while in the emergency department (ED). This failure resulted in the patient sharing a single patient treatment bay (an area divided off and used for a particular purpose) with another patient, which reportedly made Patient 64 feel as if there was no personal privacy. This failure created the potential for all patients that received services in the ED to not have the right to personal privacy during interviews, examinations, procedures and/or treatments. Findings:On October 22, 2012 at 9:50 AM, a tour of emergency department (ED) #2 was conducted with the Chief Nursing Officer (CNO) and the ED Manager. There were six single patient treatment bays that had oxygen, medical air, suction, respiratory and cardiac monitoring equipment and privacy curtains to accommodate a single patient.The six single treatment bays were further assessed and the following was noted:Bay 1 was converted into a duo treatment bay separated by a privacy screen however, there was no additional equipment (cardiac monitor, oxygen, medical air or suction) for the duo treatment bay. Bay 2 was converted into a duo treatment bay separated by a privacy screen however, there was no additional equipment (cardiac monitor, oxygen, medical air or suction) for the duo treatment bay. Bay 3 was converted into a laboratory and respiratory draw station.On October 22, 2012 at 10:00 AM, an interview was conducted with Patient 64, one of the two patients that shared the single patient treatment bay, which was separated by a privacy screen with less than two feet separating the two patients. Patient 64's father stated that he was surprised to see the current arrangement, because on a separate occasion he had visited ED #1 where the arrangement was different. Patient 64 and her father stated that the way that ED #2 was arranged did not provide for personal privacy and that they were uncomfortable with the set-up. An interview was conducted on October 22, 2012 at 10:10 AM with a Clinical Lab Tech (CLT), who was working in a patient bay area which had been converted into a "Lab Station" and "Respiratory Treatment" area. He stated that the patient bay area was converted into a Lab Station and Respiratory Treatment area soon after the hospital opened the patient bay areas. He stated that they used the patient bay area to obtain labs and that respiratory therapists use it to provide respiratory treatments.Bay 4 was converted into a duo treatment bay separated by a privacy screen. At the time of the observation, there were two patients sharing the single patient treatment bay. There was no additional equipment (cardiac monitor, oxygen, medical air or suction) for the duo treatment bay. Bay 5 was converted into a duo treatment bay separated by a privacy screen. At the time of the observation, there were two patients sharing the single patient treatment bay. There was no additional equipment (cardiac monitor, oxygen, medical air or suction) for the duo treatment bay. Bay 6 was converted into a Nursing Station.An interview was conducted on October 22, 2012 at 10:15 AM, with RN 1, who was working in the single patient treatment bay area which had been converted into a nurses' station. She stated that the patient bay area was converted into a nurses' station soon after the hospital was licensed to use them as patient bay areas. Additionally she stated, "As you can see we don't have space so we use this as a nurse station."The CNO confirmed the finding and stated that the six single patient treatment bays were defined as the "Rapid Medical Examination Area." She acknowledged and confirmed that the department had not been notified of the conversions.There were an additional seven single treatment bay beds towards the back of ED #2 that were not being utilized at the time that the observation was conducted. ED #2 had a total of 13 bays.An interview was conducted on October 22, 2012 at 10:30 AM with the facility Chief Nurse Officer (CNO). She stated that they use the single bay areas as dual rooms when they have an influx of patients. She was asked why on that day, were they sharing single bay areas if they had open bays and the unit was not full. She stated, "Yeah, I see what you mean." On October 24, 2012, a review of the hospital-wide policy and procedure titled, "Patient Rights and Responsibilities," dated July 2011, was conducted and indicated the patient's rights to personal privacy will be respected. Privacy curtains will be used in semi-private rooms. On October 25, 2012, a review of the hospitals "Bed or Service Request," dated December 31, 2011, was conducted and reflected that the request included 10 treatment bay beds, not the dual treatment bays, the nursing station or laboratory draw station/respiratory treatment areas that were observed.A review of the hospital's "Emergency Department's Scope of Service," dated February 22, 2012 was conducted and indicated that "Each room is equipped with oxygen, medical air, respiratory and cardiac monitoring equipment."

Outcome:

Deficiency cited by the California Department of Public Health: PATIENT RIGHTS: PERSONAL PRIVACY