Failure to Monitor Antibiotic Use
Penalty
Summary
The facility failed to monitor and review antibiotic use for three residents, leading to a deficiency in antibiotic stewardship. The Infection Preventionist (IP), who had been in the role for approximately one month, acknowledged that there was no system in place to track and trend antibiotic use prior to her involvement. On April 9, 2025, the IP generated the antibiotic tracking/monitoring list for the first time with the help of other staff members. The IP noted that some residents were prescribed antibiotics without an end date, which could lead to potential complications such as compromised immune systems and resistance to antibiotics. The facility's antibiotic order report from April 2025 revealed that three residents had ongoing antibiotic prescriptions without specified end dates. One resident had multiple antibiotic eye drops prescribed since December 2024 and March 2025, another resident had a topical ointment prescribed since March 2025, and a third resident had been prescribed antibiotic tablets since April 2025. The facility's policy on antibiotic stewardship, dated April 2024, emphasized the importance of appropriate use, including specifying the duration of antibiotic treatment to improve patient outcomes and minimize resistance. However, the lack of a tracking system and oversight led to the deficiency in monitoring antibiotic use effectively.