Failure to Hold Blood Pressure Medication per Physician Parameters
Penalty
Summary
Facility staff failed to follow physician-ordered parameters for administering blood pressure medication to a resident diagnosed with hypertension, atrial fibrillation, and diastolic congestive heart failure. The physician's order specified that metoprolol should be held if the resident's systolic blood pressure (SBP) was less than 100 mmHg or if the pulse was less than 55 beats per minute. Despite these clear instructions, the Medication Administration Records (MAR) for May, June, and July documented multiple instances where the resident received metoprolol even when their SBP was below the ordered threshold. The resident's care plan directed staff to monitor blood pressure as per physician orders and to administer medications accordingly. Interviews with nursing staff confirmed awareness of the medication parameters, yet documentation showed repeated administration of metoprolol outside of those parameters. Facility policy required documentation of medication administration and reasons for withholding medications, but the records indicated that the medication was given despite the resident's blood pressure being below the specified limit on numerous occasions.