Failure to Follow Physician Orders for Surgical Staple Removal and Antibiotic Administration
Penalty
Summary
The facility failed to provide appropriate treatment and care according to physician orders and professional standards for two residents. For one resident admitted with multiple diagnoses including staphylococcal arthritis, osteomyelitis, and diabetes, the after visit summary from the hospital specified that surgical staples were to be removed by facility staff two weeks post-operation. However, the Director of Nursing (DON) was unaware of this order and initially believed the resident would not allow staff to remove the staples. The DON later confirmed the order and that the resident permitted removal, but this occurred after the scheduled date. For another resident admitted with osteomyelitis, CHF, and diabetes, there were multiple physician orders for intravenous Daptomycin to treat a staph infection. The medication was not administered on two occasions, with one instance lacking a documented reason and another citing the pharmacy's care. Additionally, there was no documentation that the physician was notified about the need for order clarification or the missed antibiotic doses, as required by facility policy. The DON confirmed these lapses in medication administration and communication.