Failure to Establish and Follow Blood Pressure Parameters for Antihypertensive Medications
Penalty
Summary
The facility failed to ensure that blood pressure parameters were established and followed prior to administering blood pressure medications for one resident. The resident in question had multiple diagnoses, including diabetes mellitus, heart failure, hypertension, and bipolar disorder, and required varying levels of assistance with daily activities. The resident was prescribed amlodipine, furosemide, and lisinopril, all of which were administered as ordered throughout the month. During medication administration, the LVN reported that there were no specific parameters in place for holding blood pressure medications if the resident's blood pressure was below a certain threshold. The LVN stated that, in the absence of such parameters, she would have to administer the medication as ordered, even if the resident's blood pressure was low, unless she contacted the physician for clarification, which could delay administration. The Director of Nursing confirmed that staff should check blood pressure before administering such medications and that parameters are important to ensure safe administration. A review of facility policies indicated that medications should be administered according to prescriber orders, including any required vital sign checks, and that medication orders must include relevant clinical information and follow-up requirements. However, in this case, the orders for blood pressure medications did not include specific parameters for withholding the medication based on blood pressure readings, leading to the identified deficiency.