Failure to Obtain Vital Signs Before Administering Metoprolol
Penalty
Summary
A deficiency occurred when a nurse failed to follow a physician's order regarding the administration of metoprolol to a resident with a history of hypertension and severe cognitive impairment. The physician's order specified that the medication should be held if the resident's systolic blood pressure was less than 100 or pulse was less than 60, and vital signs were to be obtained prior to administration. However, the nurse administered the medication without checking the resident's vital signs, as observed by the surveyor. During interviews, the nurse acknowledged not knowing the resident's blood pressure or pulse before giving the medication and admitted that vital signs should have been obtained due to the parameters in the physician's order. The Director of Nursing confirmed that nurses are expected to follow physician orders, including obtaining vital signs when required by medication parameters. This failure to implement the physician's order resulted in the facility not meeting professional standards of quality for medication administration.