Failure to Monitor for Anticoagulant Complications
Penalty
Summary
A deficiency occurred when the facility failed to ensure that a licensed pharmacist performed appropriate monitoring for complications related to Xarelto, an anticoagulant medication, for one resident. The resident, who had a history of diabetes mellitus and atrial fibrillation, was admitted and readmitted to the facility and was assessed as having moderately impaired cognition and requiring substantial to maximal assistance with activities of daily living. The resident began receiving Xarelto 20 mg, but there was no evidence in the medical record that monitoring for adverse consequences, such as bleeding or bruising, was conducted as required by facility policy. During a review of the medication administration record and interviews with nursing staff, it was confirmed that monitoring for signs and symptoms of bleeding had not been initiated when the medication was started. The facility's policy specifically required daily monitoring for such complications with the administration of Xarelto, but this was not followed, as acknowledged by the licensed vocational nurse involved in the resident's care.