Failure to Assess and Monitor Self-Administration of Medications
Penalty
Summary
The facility failed to assess three residents for their ability to self-administer medications, as required by policy, and allowed medications to be left unattended at the bedside. Facility policy states that staff must remain with residents until medication administration is complete and that medications should not be left at the bedside. However, observations revealed that medications, including Nystatin powder, pills, and a red liquid medication, were found on the bedside tables or dressers of three residents. In each case, staff either left the medication for later use or failed to verify that the resident had taken the medication before leaving the room. One resident with a history of cerebral infarction, diabetes, heart failure, and paraplegia was found with Nystatin powder at the bedside, which the resident stated was left by the nurse for CNAs to apply. Another resident with end-stage renal disease and moderate cognitive impairment was observed with two pills in a clear container at the bedside, and the resident was unsure of the purpose of one of the pills. A third resident with end-stage renal disease, diabetes, and other conditions had a medication cup with red liquid and an antidiarrheal medication at the bedside, with the resident stating he had refused the medication and that the nurse had left it for him. Interviews with staff confirmed that medications were sometimes left at the bedside due to being busy or called away, and that staff did not always verify medication administration. The facility's DON and Administrator acknowledged that medications should not be left at the bedside and that self-administration assessments were required but not documented for these residents. The practice of leaving medications unattended was confirmed by multiple staff and observed during the survey.