Failure to Follow Hold Parameters for Cardiac Medication Administration
Penalty
Summary
The facility failed to follow physician orders regarding the administration of midodrine, a medication prescribed for hypotension, for one resident. The physician's order specified that the medication should be held if the resident's systolic blood pressure was greater than 140. Despite this, the resident's electronic medication administration record showed that the medication was administered multiple times when the systolic blood pressure exceeded the prescribed threshold, with readings ranging from 141 to 180. These administrations occurred on several dates over a two-month period. The resident involved was cognitively intact and had diagnoses including anemia, orthostatic hypotension, and disorders of the autonomic nervous system. During an interview, an LPN confirmed that medications with hold parameters should not be given if vital signs are outside the specified range and should be documented as held with a reason. The facility's medication administration policy also required staff to obtain and record vital signs and to hold medications when vital signs were outside physician-prescribed parameters.