Failure to Follow Physician Order for Infectious Disease Consultation
Penalty
Summary
A deficiency occurred when the facility failed to follow a physician's order for an Infectious Disease (ID) consultation for a resident with a history of unspecified valve endocarditis and infection related to a cardiac valve prosthesis. The resident, who was cognitively intact, had an active order for Doxycycline Hyclate to be administered daily until evaluated by an ID practitioner. Despite this order, there was no evidence in the electronic medical record or progress notes that the resident was ever seen by an ID specialist to assess the continued need for the antibiotic. Staff interviews confirmed that the facility was unaware that the ID consultation had not been scheduled since the initial order was made. The MDS Coordinator and the Assistant Director of Nursing/Infection Preventionist both acknowledged that the required follow-up for the ID evaluation was not completed, and the facility's own guidelines require that verbal orders be followed through as required. This lapse resulted in the resident continuing antibiotic therapy without the intended specialist evaluation.