Delayed Pain Medication Administration
Penalty
Summary
Resident #38, who was admitted with diagnoses including sepsis, a left pubic fracture, and a lumbar vertebral compression fracture, had a physician's order for oxycodone 10 mg by mouth every four hours as needed for pain. The resident was cognitively intact and reported severe pain. The care plan included administering pain medication as ordered and monitoring its effectiveness. On the date in question, the Medication Administration Record showed that the resident received his pain medication at 4:02 A.M., but the next dose was not given until 10:49 A.M., despite the order allowing for administration every four hours as needed. During this period, the resident activated his call light from 8:30 A.M. to 9:30 A.M. without response and eventually called the main phone line to request his pain medication, which he stated was due at 8:30 A.M. The nurse did not respond to the call light until around 10:40 A.M. and administered the medication at that time. The LPN caring for the resident that day confirmed she was not aware of the exact timing for the next dose and acknowledged the delay in responding to the call light and administering the medication. Facility policy requires prompt response to pain, but this was not followed in this instance.