Failure to Follow Physician Orders for IV Therapy and PICC Line Care
Penalty
Summary
The facility failed to provide care consistent with professional standards of practice and in accordance with physician orders for two residents requiring intravenous (IV) therapy. For one resident with a peripherally inserted central catheter (PICC) line, the dressing was observed to be dated nearly two weeks prior, despite a physician's order to change the dressing weekly and as needed. Staff interviews confirmed that the dressing should have been changed according to the order, but it was not, and the Director of Nursing (DON) acknowledged that nurses are expected to follow physician orders for dressing changes. In a separate incident, another resident receiving IV fluids was observed to have their infusion running at a rate higher than the physician-ordered 75 ml/hr, with the dial set between 80 and 100 ml/hr and the actual rate at approximately 90 ml/hr. The resident was unaware of the infusion rate, and an LPN later adjusted the rate to match the physician's order after being informed. Both incidents demonstrate a failure to administer IV therapy as ordered and in accordance with professional standards.