Failure to Administer Cardiac Medications per Physician Orders
Penalty
Summary
The facility failed to ensure that medications were administered according to physician orders for two residents with cardiac conditions. For one resident with diagnoses including congestive heart failure and atrial flutter, metoprolol was ordered to be held if the pulse was below 60 beats per minute. Despite this, the medication was administered on multiple occasions when the resident's pulse was below the specified threshold, as documented in the Medication Administration Record. Another resident with hypertension, atrial fibrillation, and respiratory failure had a physician order for metoprolol tartrate to be held if the heart rate was less than 60 or systolic blood pressure was less than 110. The Medication Administration Records showed that the medication was given even when the resident's pulse or blood pressure was below the ordered parameters, with no documentation that the medication was held. The DON confirmed that the medication should not have been administered under these circumstances, and facility policy required vital signs to be checked and medications to be held if not within acceptable ranges.