Failure to Follow Physician's Order for Blood Pressure Medication Administration
Penalty
Summary
The facility failed to follow a physician's order regarding the administration of blood pressure medication for a resident with diagnoses including vascular dementia, cerebral infarction, hypertension, and atrial fibrillation. The resident had severe cognitive impairment and was under a care plan that required antihypertensive medication to be administered as ordered, with monitoring for effectiveness and adverse reactions. A physician's order specified that metoprolol tartrate 25 mg should be held if the resident's systolic blood pressure was less than 100 mmHg or diastolic less than 60 mmHg. Despite this, medication was administered on multiple occasions when the resident's blood pressure readings were below these parameters. Documentation showed that metoprolol was given on several dates when the resident's blood pressure was below the ordered thresholds, with readings as low as 80/50 mmHg. During an interview, an LPN confirmed understanding of the need to hold blood pressure medication when readings were below the specified parameters and to notify the physician if systolic blood pressure was below 95 mmHg. The facility's policy required medications to be administered only as ordered by a physician, but this was not followed in the case of this resident.