Failure to Provide Safe and Appropriate Respiratory Care During Nebulizer Treatments
Penalty
Summary
The facility failed to provide respiratory care in accordance with professional standards for two residents who required nebulizer treatments. During a medication administration observation, a Qualified Medication Aide (QMA) prepared and administered a nebulizer treatment to a resident, left the resident unattended, and did not assess the resident's respiratory status before or after the treatment. The resident was not monitored during the treatment, and there was no documentation of respiratory assessments or monitoring by a licensed professional. Additionally, the facility's records for both residents lacked care plans related to their respiratory conditions and did not include interventions for nebulized treatments. Review of medication administration records showed that the majority of nebulizer treatments were administered by QMAs, despite state guidelines prohibiting QMAs from administering nebulizer treatments. Interviews with staff revealed confusion regarding the scope of practice for QMAs, with some staff unaware of the restrictions. The facility did not have a policy outlining the QMA scope of practice, and the job description and competency evaluations for QMAs did not address nebulizer treatments. The facility's own policy required licensed staff to assess and monitor residents during nebulizer treatments, but this was not followed.