Failure to Monitor and Review Antibiotic Use
Penalty
Summary
The facility failed to ensure an effective system to monitor antibiotic use for four residents, as evidenced by interviews and record reviews. Infection control logs and medical records showed that multiple residents were prescribed antibiotics without adequate documentation of clinical indications or review of appropriateness. For example, one resident was started on Macrobid for confusion, but the medical record did not document urinary symptoms or urinalysis and culture results. Another resident was prescribed antibiotics for reported urinary symptoms, but the medical record lacked documentation of those symptoms and culture results. Additionally, a newly admitted resident was prescribed metronidazole without documentation of a review for appropriateness, and another was prescribed Macrobid for an asymptomatic urinary tract infection without documentation of signs or symptoms. Further review revealed that the infection control logs and medical records did not contain evidence of review for the appropriateness of antibiotics prescribed to these residents. During interviews, the Infection Preventionist (IP) stated that they input data into a computerized checklist and reviewed labs and referrals but did not consult with the physician regarding the appropriateness of antibiotic use. The Director of Nursing (DON) and IP were unable to provide documentation or further explanation regarding the review of antibiotic appropriateness for the affected residents by the end of the survey.