Failure to Honor Resident's Right to Self-Determination in Medication Administration
Penalty
Summary
Facility staff failed to honor a resident's right to self-determination and participation in care by not administering a physician-ordered topical medication, Triamcinolone Acetonide External Cream 0.1%, to the resident's right elbow. The resident, who was alert, oriented, and able to communicate through lip reading and nodding, had a recurring rash diagnosed as fungal dermatitis. Despite the resident's ability to make her own decisions, staff did not offer the medication to her, instead deferring to the refusal of her representative, who was not the designated decision maker. The resident expressed that the ointment provided relief from itching, but staff did not consult her directly regarding her preference for treatment. Interviews with facility staff, including a treatment nurse and the Assistant Director of Nursing, confirmed that the resident was capable of making her own medical decisions and should have been involved in her care planning and medication administration. The facility's policy on resident rights also emphasized the importance of resident involvement in treatment decisions. The failure to administer the prescribed medication and to involve the resident in her own care planning constituted a violation of her rights as outlined in facility policy and federal and state regulations.