Unlicensed Staff Applied Prescription Medication Without Physician Order
Penalty
Summary
Certified Nursing Assistants (CNAs), including CNA 4, applied triamcinolone acetonide ointment 0.1%, a prescription medication, to a resident without a physician's order and in violation of the facility's Administering Medications policy. The resident, who was admitted with diagnoses including type 2 diabetes mellitus and hyperglycemia, had intact cognition and required varying levels of assistance with personal care. The resident reported that CNAs would apply the ointment to her buttocks daily or upon request, and CNA 4 confirmed applying the ointment to multiple areas as directed by the resident, without consulting a licensed nurse or verifying a physician's order. Record review and staff interviews revealed that the resident did not have a current order for the medication, nor was there documentation of a self-administration evaluation or care plan. The facility's policy specified that only licensed or permitted personnel may administer medications. Both CNA 4 and a registered nurse acknowledged that CNAs are not authorized to administer prescription medications, and doing so could potentially cause harm. The deficiency was identified through observation, interview, and record review.