Failure to Administer Blood Pressure Medications per Physician Orders
Penalty
Summary
The facility failed to administer blood pressure medications according to physician orders for two residents with significant cardiovascular and respiratory diagnoses. For one resident with essential hypertension, COPD, and pulmonary fibrosis, the care plan identified a risk for unstable blood pressures and included a physician's order to administer Lasix daily, with instructions to hold the medication if the systolic blood pressure was less than 100. However, medication administration records showed that Lasix was given on multiple occasions without recording the systolic blood pressure, and on one occasion, it was administered when the systolic blood pressure was below the hold parameter. Interviews confirmed that blood pressure should have been checked and documented prior to administration, and the medication should have been held if parameters were not met. For another resident with hypertension, congestive heart failure, atrial fibrillation, and pulmonary edema, the care plan required administration of hydralazine as needed for systolic blood pressure greater than 160. Despite documented blood pressure readings above this threshold on several dates, the medication was not administered as ordered. Staff interviews confirmed that the as-needed medication should have been given and documented according to the physician's order. Facility policy also required medications to be administered only as prescribed and for pertinent information, such as blood pressure, to be recorded prior to administration.