Failure to Follow Physician Orders for Medication Administration
Penalty
Summary
The facility failed to ensure that residents received treatment and care in accordance with physician orders and professional standards of practice for two residents. For one resident, a physician ordered a seven-day course of Cipro 500 mg twice daily for a urinary tract infection, totaling 14 doses. Documentation showed that only 13 doses were administered, with one dose missed due to the medication not being available as noted in the nursing record. The Director of Nursing confirmed there was no documentation that the full course was given as ordered. For another resident, physician orders specified the use of acetaminophen for general discomfort and hydrocodone-acetaminophen for pain rated 6 to 10 on the pain scale. Review of the medication administration record revealed that hydrocodone-acetaminophen was administered on ten occasions when the resident's pain level was below the ordered threshold, including instances where the pain level was documented as 0, 3, 4, or 5. The Director of Nursing confirmed that the medication was given outside the parameters set by the physician's order.