Failure to Administer Pneumococcal Vaccine After Consent and Order
Penalty
Summary
The facility failed to ensure that a pneumococcal vaccine was administered to one of five sampled residents reviewed for immunizations. The resident was admitted to the facility and was found to be alert and oriented, with documentation indicating that the pneumococcal vaccination was not up to date. The resident signed an acknowledgement form indicating receipt of the vaccine information sheet and consented to receive any needed vaccines. A physician's order was present, authorizing the administration of the pneumococcal vaccine if indicated. The electronic health record showed the vaccine status as pending, with consent confirmed by the infection preventionist. Despite the presence of consent and a physician's order, there was no documentation in the resident's record that the pneumococcal vaccine was administered. The infection preventionist confirmed that the vaccine had not been given and that it was not entered on the Medication Administration Record as required. The Chief Nursing Officer stated that the expectation was for vaccinations to be administered after obtaining orders and consents, but this process was not followed in this instance.