Failure to Notify Physician and POA of Missed Antibiotic Doses
Penalty
Summary
A resident with diagnoses including osteomyelitis of the left ankle/foot and dementia, and who had a family member designated as Power of Attorney (POA), was prescribed IV ampicillin-sulbactam every six hours for a wound infection. The Medication Administration Record (MAR) showed that the antibiotic was unavailable and not administered at four scheduled times over two days. There was no documentation indicating that the resident's physician or POA had been notified about the missed doses. During an interview, the Director of Nursing confirmed that both the physician and POA should have been notified of the missed medication. Facility policy required that such notifications be made and documented in the medical record, but this was not done.