Medication Administration, Storage, and Labeling Deficiencies
Penalty
Summary
A nurse administered a prescribed dose of ferrous sulfate liquid solution to a resident via gastrostomy tube but was unable to state the total dose in milligrams, and the medication bottle label did not display the prescribed total dose. Additionally, medications intended for different routes of administration, including oral medications, enemas, suppositories, and eye ointment, were observed stored together on the same shelf in the medication room, contrary to facility policy requiring separation by route. The Director of Nursing confirmed that medications of different routes were not separated as required. An opened vial of insulin was found in a medication cart with an open date exceeding the facility's 28-day discard policy, and the nurse confirmed it should have been discarded and replaced. Furthermore, a resident was found to have an opened bottle of antifungal powder at bedside, and both the resident and a nurse confirmed that nursing staff had applied the powder without a physician's order. The Director of Nursing later confirmed that the antifungal powder is considered a medication and should not have been administered without a physician's order.