Failure to Timely Administer Prescribed Antibiotic
Penalty
Summary
A deficiency occurred when the facility failed to provide a prescribed antibiotic in a timely manner to a resident with multiple complex diagnoses, including chronic osteomyelitis, cerebral infarction, hemiplegia, epilepsy, and a history of urinary tract infections. The resident was admitted with these conditions and later developed symptoms of dysuria and altered mental status, prompting a urinalysis with culture and sensitivity. The preliminary lab results were available in the facility's electronic medical record system on the same day the sample was collected. However, the order for the antibiotic Cefdinir was not entered until the following day, with a start date set for yet another day later. Despite the availability of the antibiotic in the facility's emergency kit, the resident did not receive the medication on the day it was ordered. Further complicating the situation, the resident reported an allergy to Cefdinir after the order was placed, leading to a change in the prescribed antibiotic to Macrobid. The Assistant Director of Nursing confirmed that the resident should have received the antibiotic from the emergency kit on the day it was ordered, but this did not occur. The surveyor was unable to reach the nurse responsible for entering the original order during the investigation.