Improper Nebulizer Administration Procedure
Penalty
Summary
A deficiency occurred when a licensed vocational nurse (LVN) failed to administer a nebulized medication in accordance with professional standards of practice. During a medication pass, the LVN added sodium chloride 3% inhalation solution to the nebulizer cup and turned on the nebulizer machine before ensuring the resident had properly placed the facemask over their nose and mouth. Mist began to be released from the nebulizer before the resident applied the mask, resulting in the potential for medication to disperse into the room rather than being fully inhaled by the resident. The LVN later acknowledged that the mask was not in place before the machine was activated and that some medication might not have been delivered to the resident as prescribed. The resident involved had a medical history including chronic obstructive pulmonary disease (COPD) with acute exacerbation, pneumonia, and chronic respiratory failure with hypoxia. The resident had a physician's order for sodium chloride inhalation solution via nebulizer twice daily for COPD management. Both the LVN and the Director of Nursing (DON) confirmed that the correct procedure was not followed, as the mask should have been properly applied before the nebulizer was turned on, in accordance with facility policy and national guidelines.