Failure to Monitor Hemoglobin Prior to Epogen Administration
Penalty
Summary
The facility failed to ensure that a resident’s drug regimen was free from unnecessary medications by not monitoring hemoglobin levels prior to administering Epogen, a medication used to treat anemia. The resident in question had diagnoses including end stage renal disease, chronic obstructive pulmonary disease, and anemia, and required varying levels of assistance with daily activities. According to the physician’s order, Epogen was to be administered weekly for anemia, with instructions to hold the medication if the hemoglobin level was greater than 11. However, review of the Medication Administration Record showed that Epogen was administered on at least two occasions without evidence that hemoglobin levels were checked beforehand. Interviews with nursing staff and the Director of Nursing confirmed that hemoglobin levels should have been monitored weekly prior to each administration of Epogen, in accordance with both the physician’s order and the manufacturer’s guidelines. The facility’s policy on medication administration also required medications to be given as prescribed and in a safe manner. The failure to monitor hemoglobin levels before administering Epogen constituted a deficiency, as it did not ensure the medication was indicated for the resident at the time of administration.