Failure to Clarify Medication Indication for Marinol
Penalty
Summary
The facility failed to ensure that a resident’s drug regimen was free from unnecessary medications by not clarifying the order indication for Marinol. The resident, who had diagnoses including encephalopathy, schizophrenia, and recurrent major depressive disorder, was initially prescribed Megestrol for poor appetite. Following a medication regimen review, Megestrol was discontinued due to associated risks, and Marinol was started. However, the order for Marinol was written for 'vomiting,' even though the resident was not experiencing vomiting, and the intended use was for poor appetite. During interviews and record reviews, it was confirmed that the Director of Nursing (DON) recognized the discrepancy in the medication order and acknowledged that the licensed nurse should have clarified the indication with the physician. The facility’s policy required that medication orders include the condition or diagnosis for which the medication is ordered, but this was not followed. As a result, the staff were not properly informed of the correct indication for Marinol, leading to a deficiency in medication management for the resident.