Failure to Follow Physician Orders for PICC Line Care and Antibiotic Administration
Penalty
Summary
The facility failed to adhere to physician orders for a resident who was admitted with a PICC line for intravenous antibiotic therapy. The resident, diagnosed with an intraspinal abscess, granuloma, urinary tract infection, and heart disease, was prescribed Cefazolin to be administered intravenously every 8 hours. However, the Medication Administration Record (MAR) showed that the antibiotic was not administered as scheduled on multiple occasions throughout November 2024. Additionally, the facility did not document the required flushing of the PICC line with Sodium Chloride Flush Solution every shift, as ordered by the physician. Further deficiencies were noted in the care of the PICC line, as the facility failed to change the PICC line dressing and end cap every 7 days, and did not perform the necessary measurements of the arm circumference and external catheter length as ordered. These omissions were confirmed during an interview with the Director of Nursing, who acknowledged the lack of documented evidence that nursing staff consistently followed the prescribed physician orders for the resident.
Plan Of Correction
1. Resident #18 has discharged from the facility. 2. An audit will be completed by the DON, or designee, of all in-house residents with physician orders for antibiotics via PICC line to ensure that the physician orders for the administration and care are being followed and documented. 3. Education will be provided to all licensed nursing staff on following physician orders for the administration of antibiotics via PICC line as well as the care of the PICC line and associated documentation. 4. The DON, or designee, will complete audits on residents with physician orders for antibiotics via PICC line to ensure physician orders for the administration and care of PICC line are being followed and documented. Audits will be reviewed at the QAA committee meetings x 3 months and then re-evaluated.