Failure to Follow Antibiotic Stewardship Protocol Prior to Prescribing Antibiotics
Penalty
Summary
The facility failed to implement its Antibiotic Stewardship protocol for one of three sampled residents by prescribing an antibiotic without meeting established criteria. Specifically, a resident with a history of hypertension and diabetes mellitus, who was admitted with severe cognitive impairment and required supervision for daily activities, was prescribed Doxycycline for left toe cellulitis. The order for the antibiotic was placed without first obtaining a wound culture or confirming that the resident met McGreer's Criteria for infection, as required by facility policy. Interviews with the Infection Prevention Nurse and the Director of Nursing confirmed that a wound culture should have been collected prior to starting the antibiotic to ensure appropriate treatment and adherence to the facility's protocol. The facility's policy states that antibiotics should only be prescribed when clinical criteria for infection are met and pathogen susceptibility is determined. The failure to follow these procedures was confirmed through record review and staff interviews.