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F0694
D

Failure to Follow IV Catheter Care Protocols

Martinsburg, Pennsylvania Survey Completed on 01-24-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure proper care and maintenance of intravenous (IV) catheters for a resident, as evidenced by the lack of adherence to physician's orders and facility policy. Specifically, the facility did not follow the physician's orders for flushing the IV catheter with normal saline every shift for a resident receiving Meropenem for a urinary tract infection. The Medication Administration Records (MARs) showed no documentation of the required saline flushes on specific shifts, and there was no evidence that the IV catheter was flushed before and after the administration of Meropenem, as required by the facility's policy. Additionally, there was no documented evidence that the resident's physician was contacted for orders regarding the care and maintenance of the IV catheter from the time the orders were discontinued until the catheter was removed. The Director of Nursing confirmed these deficiencies, indicating a failure to ensure that physician's orders were followed and that the facility's policy for IV catheter care was adhered to, resulting in a lapse in the standard of care provided to the resident.

Plan Of Correction

A medication error form will be initiated for the staff who failed to administer the normal saline flush as ordered by the physician/policy. Any resident ordered a normal saline flush is at risk for this deficiency. All licensed nursing staff will be re-educated on the intravenous medication administration policy. The Director of Nursing or designee will conduct audits on all intravenous medication and flushes weekly times 4 weeks. Audits will be reviewed by the Quality Assurance Performance Improvement committee for results, areas of improvement and/or continued auditing.

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