Missing Competency Validation for Medication Administration via Enteral Feeding Tube
Penalty
Summary
The facility failed to ensure that a Licensed Vocational Nurse (LVN) was competent in administering medication via a gastrostomy tube (GT) in accordance with the facility's policy and procedure. During interviews and record reviews, it was found that the required competency validation form for medication administration with enteral formulas was missing from the LVN's employment file. The Director of Staff Development (DSD) and the Director of Nursing (DON) both confirmed that there was no documentation of this competency validation, and the DSD acknowledged that some review dates were also missing from other initial competency validations, such as hand hygiene, medication administration, and head-to-toe assessment. Additionally, there was no documentation indicating which nursing station the LVN was oriented to, which is necessary for understanding the specific diagnoses and residents under their care. The facility's policies require that staff receive training and competency validation for tasks such as medication administration via enteral feeding tubes, hand hygiene, and the use of personal protective equipment. However, the lack of documentation in the LVN's file indicated that these requirements were not met or properly recorded. The DSD admitted to forgetting to document review dates on some competencies, and the DON had not reviewed the LVN's file to confirm completion of the necessary validations. This lack of documentation and oversight resulted in the facility's inability to verify that the LVN possessed the required competencies to safely administer medications via a gastrostomy tube.