Failure to Ensure Nursing Staff Competency in Medication Administration and Monitoring
Penalty
Summary
Licensed nursing staff failed to demonstrate the necessary competencies and skills to safely administer medications as ordered for two residents. In one instance, an LVN did not check a resident's blood pressure in the supine position as required before administering Droxidopa, a medication prescribed for orthostatic hypotension. Instead, the LVN measured the blood pressure while the resident was upright, despite the physician's order and a black box warning specifying the need for a supine reading. The Director of Nursing confirmed that the correct procedure was not followed, which could have resulted in an inaccurate assessment prior to medication administration. In another case, a resident with orders for insulin administration based on blood sugar levels did not have their blood sugar checked or documented at two specified times. The Medication Administration Record did not show evidence of blood sugar checks on the dates and times required by the physician's order. The DON acknowledged the absence of documentation and emphasized the importance of proper blood sugar monitoring and documentation for residents receiving insulin. Both incidents were identified through observation, interview, and record review. The facility's policy requires all nursing staff to meet specific competency requirements based on resident needs, as determined by assessments and care plans. The failures in these cases demonstrate that the nursing staff did not meet the required competencies for medication administration and monitoring as outlined in facility policy and physician orders.