Failure to Follow Physician Orders for Blood Sugar Notification and Antibiotic Administration
Penalty
Summary
The facility failed to ensure that physician's orders were followed for a resident with diabetes and osteomyelitis. Specifically, the resident had multiple blood sugar readings greater than 400, as documented in the Medication Administration Records (MAR) over several months. Despite physician orders to notify the physician if blood sugar exceeded 400, there was no documentation that the physician was notified on any of these occasions. The Director of Nursing (DON) confirmed that there was no evidence of physician notification as required by the orders. Additionally, the same resident was prescribed ceftriaxone to treat a chronic bone infection (osteomyelitis) in the left ankle and foot. The MAR indicated that the resident did not receive the antibiotic on three specific dates, and there was no documentation to confirm administration. The DON acknowledged that if medication administration was not documented, there was no way to verify that the resident received the prescribed treatment. Facility policies reviewed indicated that medications should be administered and documented according to prescriber orders, and that staff should report issues affecting diabetes management.