Failure to Follow Physician Orders for Insulin Administration
Penalty
Summary
Licensed nursing staff failed to follow physician orders for the administration of insulin to a resident with type 2 diabetes mellitus and a long-term insulin regimen. The facility's policy required verification of a physician's medication order, including specific parameters for administration. The physician's order specified that Novolog insulin should be administered subcutaneously with meals, but only if the resident's blood glucose level was 100 mg/dl or higher. Despite these instructions, the resident's Medication Administration Records showed that nursing staff administered Novolog insulin on multiple occasions when the resident's blood glucose levels were below the prescribed threshold. Specifically, insulin was given when blood glucose readings were 78 mg/dl, 92 mg/dl, and 96 mg/dl, all of which were below the physician's specified parameter. The Director of Nursing confirmed that these administrations were outside the prescribed parameters.