Failure to Ensure Medication Administration According to Professional Standards
Penalty
Summary
Nursing staff failed to ensure that a resident was administered medications in accordance with professional standards of quality. The resident, who was cognitively intact and had not been assessed or approved to self-administer medications, was observed with multiple medications left in a cup on the overbed table on two separate occasions. The resident expressed confusion about when the medications were provided and indicated that they had not yet taken them. Review of the medical record confirmed that the resident had requested nursing staff to administer medications and had not been assessed for self-administration. Interviews with nursing staff and the unit manager confirmed that the resident was not on the list of those permitted to self-administer medications. Despite this, a nurse admitted to not waiting to ensure the resident had taken all medications before leaving the room. The facility's policy requires that only licensed personnel administer medications and that administration is completed in accordance with prescriber orders, including ensuring medications are actually taken. The failure to confirm medication ingestion resulted in the resident having unsupervised access to prescribed medications.