Failure to Monitor Blood Pressure Prior to Antihypertensive Administration
Penalty
Summary
A deficiency was identified when a resident with diagnoses of hypertension and paroxysmal atrial fibrillation was administered Metoprolol Succinate ER 25 mg daily without consistent monitoring of blood pressure as required by physician orders. The physician's order specified that the medication should be held if the resident's systolic blood pressure was less than 110, necessitating a blood pressure check prior to each administration. However, review of the Medication Administration Records (MAR) and the electronic health record (EHR) revealed that blood pressure readings were not documented daily, and there was no evidence that blood pressure was checked before each dose was given. During an interview, the Director of Nursing (DON) confirmed that blood pressure should have been checked daily prior to administering the medication, in accordance with the order. The DON also verified, upon review of the records, that the required monitoring was not performed. The facility's policy on medication administration emphasizes adherence to provider orders and safe medication practices, but these procedures were not followed in this instance, resulting in the administration of an antihypertensive medication without the necessary monitoring.