Failure to Monitor for Adverse Effects of Antibiotic Therapy
Penalty
Summary
The facility failed to ensure that a resident's drug regimen was free from unnecessary drugs by not monitoring for adverse effects associated with the administration of Cefepime HCl, an antibiotic prescribed for osteomyelitis. The resident, who was admitted with diagnoses including a local skin infection, type 2 diabetes mellitus, and a skin ulcer, was alert, oriented, and had intact cognition at the time of the incident. The order for Cefepime HCl did not include instructions for monitoring adverse effects, and there was no documentation that such monitoring occurred during the course of treatment. Interviews with nursing staff and the Director of Nursing confirmed that Cefepime is considered a significant medication requiring monitoring for adverse effects, and that such monitoring is necessary to promptly report any negative reactions to the physician. Facility policies reviewed indicated that nursing staff are expected to monitor for and document any adverse drug reactions, including side effects or allergic responses, and to notify the attending physician as appropriate. However, these procedures were not followed in this case, resulting in a deficiency related to the lack of monitoring for adverse effects of the antibiotic.