Delayed and Incomplete IV Antibiotic Administration
Penalty
Summary
The facility failed to ensure the timely and appropriate administration of intravenous (IV) antibiotics for a resident diagnosed with a urinary tract infection. The physician ordered IV ceftriaxone for the resident, who had a history of stroke with left-sided weakness and atrial fibrillation, but the order did not specify the infusion rate. As a result, the order was incomplete and did not meet professional standards of practice or the facility's own policy, which requires documentation of the total time infused. The resident's medication administration record showed that the first dose of IV ceftriaxone was administered nearly 15 hours after the order was placed, significantly exceeding the facility's expectation that antibiotics be given within 4 hours of the physician's order. Interviews with the Director of Nursing confirmed that the delay in administration and the lack of an infusion rate in the physician's order were not consistent with facility policy or professional standards. The family member of the resident was also unsure if the antibiotics had been started as required. The documentation review further revealed that there was no way for nursing staff to document the rate at which the IV ceftriaxone was infused, as required by policy.