A nursing and rehab center in North Carolina is being investigated by the State Agency after a resident accidently set herself on fire in her room. The local police department reported that a woman at the nursing home was connected to an oxygen tank and tried to smoke a cigarette, causing a burst of flames that badly burned her. Staff members used blankets and fire extinguishers to put out the flames. The woman was transferred to a hospital with burns to her torso.
The following statement was released: “An event occurred at [the center] involving a resident who had been with us and part of our family for over two years,” a spokesperson said. “As this is an ongoing investigation and due to confidentiality, we cannot provide any specific resident information at this time.”
The North Carolina Department of Health and Human Services has opened an investigation into the incident.
Issue:
According to F695 in the State Operations Manual, Appendix PP, if a resident is ambulatory with his/her oxygen delivery system, the resident must be informed of safety precautions and prohibitions for oxygen, such as where smoking is allowed or other hazardous areas, and staff should monitor to assure the resident adheres to the safety rules for oxygen. F926 states that facilities must establish policies, in accordance with applicable federal, state, and local laws and regulations, regarding smoking, smoking areas, and smoking safety that also take into account nonsmoking residents. It also states that the use of oxygen in smoking areas and while smoking is forbidden.
Discussion Points:
- Review your policies and procedures for smoking, smoking areas, and smoking safety. If your facility is smoke-free, ensure your policies include a process for informing new residents of that fact before admission, as well as safe smoking provisions for any residents who are grandfathered to smoke. Additionally, review your policies and procedures for those receiving supplemental oxygen, and for supervision of residents. Update as necessary.
- Train all appropriate staff on your policies and procedures for smoking safety and supervision of residents. Document that these trainings occurred and file the signed documents in each employee’s education file.
- Periodically audit to ensure that smoking safety measures are being followed, that residents have adequate supervision, and that care plans addressing safe smoking are current.
