Failure to Administer and Monitor Narcotic Pain Medication per Physician Orders
Penalty
Summary
The facility failed to administer narcotic pain medication according to the physician's orders for one resident. The resident, who had diagnoses including osteomyelitis, complete traumatic amputation of the left lower leg, unspecified pain, and inguinal hernia, had a physician's order for Norco 5-325 mg to be given by mouth every 12 hours as needed for pain levels between 4 and 10 on the pain scale. However, the Medication Administration Record (MAR) showed that Norco was administered on multiple occasions when the resident's pain scale was documented as 0, which was outside the prescribed parameters. Additionally, there was no documentation of reassessment or re-evaluation of the effectiveness of the narcotic medication after administration on several dates. The facility's pain management policy required licensed nurses to assess and document pain and the resident's response to interventions, but this was not done as required. The Director of Nursing confirmed that the medication was given outside the ordered parameters and that reassessment documentation was missing.