Failure to Ensure Professional Standards in IV Medication Administration
Penalty
Summary
The facility failed to ensure that nursing services met professional standards of quality regarding the administration of intravenous (IV) medication via a peripheral IV. Specifically, the facility did not have a written policy or protocols specifying which licensed nursing staff (RN or LPN) were responsible for the infusion of physician-ordered IV fluids or medications. Additionally, there was no documented evidence that LPNs employed at the facility had completed a Board-approved educational program for IV therapy, nor was there evidence of annual in-service training on IV administration for LPNs who may have completed such a program. A clinical record review revealed that a resident with dementia was ordered to receive Meropenem-Sodium Chloride Intravenous Solution for a urinary tract infection. The resident had a peripheral IV placed, and the Medication Administration Record (MAR) indicated that several LPNs signed as having administered the IV antibiotic over a period of several days. However, during staff interviews, one LPN stated she had not actually administered the IV medication but had signed the MAR, while an RN had performed the administration. The LPN also confirmed she had not received education on IV medication administration at the facility. Interviews with the administrator and DON confirmed the absence of written policies or protocols for LPNs to administer IV fluids or medications and the lack of documentation regarding LPNs' completion of required IV therapy education. The DON also confirmed that facility policy required the nurse administering the medication to sign the MAR, but there was no evidence of education or supervision for LPNs regarding IV administration. These findings demonstrate a failure to ensure that nursing services, specifically IV medication administration, met professional standards of quality as required by state regulations.