Failure to Administer Physician-Ordered Medications and Wound Care
Penalty
Summary
Facility staff failed to provide medications and wound care treatments as ordered by physicians for two of six residents. For one resident with diagnoses including rectal cancer, muscle wasting, and diabetes mellitus, physician orders required specific wound care to the buttocks twice daily, including washing, packing with Dakins solution, and applying Calmoseptine, as well as administration of an antidepressant medication. Review of the Treatment Administration Record (TAR) and Medication Administration Record (MAR) revealed multiple missed wound care treatments and several days when the antidepressant medication was not administered due to pending delivery. These omissions were confirmed by the Wound Care Nurse and the Director of Nursing during interviews. Another resident with high blood pressure, low back pain, and bacterial arthritis of the left knee had physician orders for daily wound care to the left knee, ensuring steri strips remained in place and monitoring for infection. The TAR indicated that wound care was not provided on two separate occasions as ordered. The Director of Nursing confirmed these missed treatments during interviews. Facility policies reviewed indicated that medications and treatments are to be administered safely, timely, and as prescribed, with proper documentation and timely reordering of medications. Despite these policies, the facility did not consistently follow physician orders for medication administration and wound care for the two residents, resulting in the identified deficiencies.