Delay in Administration of Ordered Antibiotic
Penalty
Summary
A deficiency occurred when a resident with diagnoses including wet gangrene, osteomyelitis, and dementia was not administered Amoxicillin-clavulanate (Augmentin) as ordered by the discharging physician. The hospital discharge instructions specified that the resident was to receive Augmentin every eight hours, with the next dose due on the evening of admission. Although the physician order was entered with the correct start date, the medication was not administered until nearly two days later. Facility records and staff interviews revealed that the delay was due to the medication not being delivered promptly and a lack of awareness that Augmentin was available in the facility's convenience box. Nursing staff documented that the medication was unavailable, and the DON confirmed that the nurse did not know the convenience box contained the required medication. The delay in administration was further compounded by communication with the pharmacy regarding medication availability.