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F0658
D

Failure to Use PPE During Hazardous Drug Administration

Livermore, California Survey Completed on 05-16-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

Nursing staff failed to follow professional standards and facility policy for the safe handling of hazardous drugs during medication administration. During a medication pass observation, an LVN administered a tablet of finasteride, which was clearly labeled as a hazardous drug, to a resident without wearing gloves. The LVN removed the tablet from the bubble pack with bare hands and placed it into a medication cup before giving it to the resident. The resident’s Medication Administration Record did not indicate the need for gloves or other precautions when administering the drug. The facility’s policy required the use of appropriate personal protective equipment, including gloves, when handling hazardous drugs. Additionally, CDC and NIOSH guidelines specify that gloves should be used when handling intact tablets of hazardous medications such as finasteride. The DON confirmed that nurses are expected to wear gloves to minimize contact and protect themselves when handling these medications. This failure to adhere to established guidelines and facility policy had the potential to pose health risks to both staff and residents.

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