Geisinger Wyoming Gets 2nd Citation

By Walter F. Roche Jr.

For the second time in a matter of a month, a Wilkes Barre hospital has been cited by state regulators for failing to comply with minimum standards.
In a report just made public by the state Health Department, surveyors charged that staffers at the Geisinger - Wyoming Medical Center failed to assign a person to constantly monitor a patient who had expressed thoughts of suicide.
"A patient has a right to receive care in a safe setting," the report on the 286 bed hospital states.
The same facility was cited in June for failing to complete a blood test ordered by a physician for a patient who suffered a stroke days after the test was postponed.
According to the latest report state inspectors declared a state of immediate jeopardy on Aug. 2 after they reviewed hospital records on the care provided to the suicidal patient.
The patient had admitted to having suicidal thoughts "related to her medical condition and chronic pain."
Although the patient's condition mandated that a sitter be assigned to provide constant watch there was "no documentation that a sitter was ordered."
At 12:58 p.m. on July 25 a nurse entered the patient's room to find the patient had a call bell wire held very tightly across her neck. Only then was a sitter assigned to keep the patient under constant watch, according to the state report.
A Geisinger spokesman said that when the patient first came to the hospital she was properly screened and judged not at risk for suicide and not in need of a sitter.
"Days later, when the patient’s change in mood constituted reason for concern, a psychiatric consultation was performed, and a 1:1 sitter was recommended. Before the sitter could be assigned, a provider re-entered the patient’s room and found the patient exhibiting behavior that suggested self-harm," the spokesman continued.
From that point on the patient was not left alone, according to the spokesman, who added that the hospital self-reported the incident to the state.
The hospital's two first plans of correction were rejected as inadequate. The third version was accepted and the state of immediate jeopardy was finally lifted at 5:43 p.m. In that third plan the hospital agreed to make the assignment of a sitter automatic with specified diagnoses. If a sitter is not immediately available a nurse must remain with the patient until a sitter arrives. The plan also calls for audits to be performed to ensure staff are following the revised procedures.
The spokesman said the action plan approved by the state allows for easy implementation of suicide precautions and assignment of sitters.
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