Failure to Follow Physician's Order for Medication Parameters
Penalty
No penalty information released
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Summary
A deficiency was identified when a resident was administered metoprolol tartrate 25 mg despite physician orders specifying the medication should be held if the systolic blood pressure (SBP) was less than 110 or the heart rate (HR) was less than 60. The medication administration record (MAR) showed that the resident received the medication on multiple occasions when the HR was below the ordered parameter, including instances where the HR was 55 and 58. Interviews with nursing staff confirmed that the medication was given outside of the prescribed parameters and that the expectation was to hold the medication and notify the provider if parameters were not met. There were no adverse effects documented as a result of these administrations.