CNA Administers Prescribed Medication Instead of Nurse
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) administered a prescribed medication, Nystatin powder, to a resident's skin folds, rather than a licensed nurse as required. The resident, who had multiple diagnoses including type 2 diabetes mellitus with diabetic neuropathy, metabolic encephalopathy, chronic kidney disease stage 4, and acute and subacute hepatic failure, had a physician's order for Nystatin powder to be applied topically three times a day for a candida yeast skin infection. During a survey, the prescribed Nystatin powder was observed on the resident's bedside table, and both the resident and CNA confirmed that the CNA applied the medication after the resident's shower that morning. Further interviews revealed that the CNA routinely applied the Nystatin powder to the resident's groin folds, especially on shower days, due to difficulty locating a nurse. The registered nurse (RN) on the unit acknowledged that CNAs often applied the medication, and the director of nursing (DON) confirmed that it was not acceptable for CNAs to administer prescribed medications, stating that only nurses should do so unless the resident has been assessed and deemed capable of self-administration. The storage of the medication at the bedside was also discussed, with the DON indicating it was only appropriate if the resident could self-administer, which had not been established.