On 7/5/23 at approximately 1820, client became angry and punched a wall twice with her right hand. Upon initial assessment, the RN noted the onstage swelling and bruising with range of motion present. The physician was notified of the event after the initial assessment. The plan of action moving forward included to continue to monitor affected area and update physician with status changes, as well as offer comfort measures including ice packs and prn pain medications for relief. Upon assessment of client’s hand today, 7/6/23, the RN noted that their right knuckle appeared moderately swollen with complaints of tenderness and lessened range of motion compared to yesterday evening’s assessment. The physician was notified of the assessment and recommended to have client sent out for x-rays to rule out a possible fracture. Client is currently at Northwest Arkansas Children’s Hospital awaiting x-ray results.
Corrective action: Work in collaboration with the treatment team to help find ways to better assist when she has anger impulses without risking self-injurious behavior. Licensing narrative: 7/13/2023 Licensing Specialist reviewed the provider reported incident. X-ray results have been requested from the facility.