Improper Administration of Otic Medication
Penalty
Summary
The facility failed to ensure that a resident's Ciprodex otic (ciprofloxacin and dexamethasone) ear drops were administered according to professional standards of practice and the facility's own policy. During a medication pass, an LVN did not shake the ear suspension prior to administration and instilled one drop at a time into the resident's right ear, waiting five minutes between each drop, resulting in a total administration time of 20 minutes. The resident, who had moderately impaired cognition and required significant assistance with activities of daily living, complained of neck pain during the process due to prolonged tilting of the head. The facility's policy specified that the prescribed number of drops should be instilled into the ear canal, followed by instructing the resident to remain in the same position for approximately five minutes. The LVN, however, was following incorrect instructions received during an in-service, which led to the deviation from policy. The DON confirmed that the medication should have been administered as four drops at once, not with intervals, and acknowledged that the resident could experience discomfort and potentially refuse future doses as a result of the improper administration.