Failure to Adhere to Professional Standards in Narcotic Medication Administration and Documentation
Penalty
Summary
The facility failed to meet professional standards of practice in the administration and documentation of narcotic pain medications for four residents. Staff administered narcotic medications earlier than the prescribed intervals, with multiple instances where medications were given less than the ordered four or six hours apart. In some cases, residents received higher doses than ordered or duplicate doses within a short time frame. These actions were documented in the controlled drug records and medication administration records (MARs), showing discrepancies in timing and dosage. Additionally, staff did not consistently notify providers when residents required pain medications more frequently than ordered. There was no documentation indicating that providers were informed about the increased frequency of pain medication requests, which would have been necessary for proper pain management assessment and potential adjustment of orders. Interviews with staff and the nurse practitioner confirmed that provider notification was expected but did not occur, and that the nurse practitioner relied on MAR documentation to assess pain management needs. Documentation practices were also deficient, as staff failed to consistently record the administration of narcotic medications and the reassessment of pain effectiveness on the MARs. The lack of documentation meant that subsequent staff and providers were not fully informed about the residents' pain management and medication usage. Interviews with staff and the DON revealed a lack of clarity regarding the timing of PRN medication administration and the importance of thorough documentation, further contributing to the deficiencies identified.