Failure to Administer Metoclopramide as Ordered Before Meals
Penalty
Summary
A deficiency occurred when a resident with a history of gastroparesis, acute kidney failure, depression, anxiety, and hypertension did not receive her prescribed medication, metoclopramide, as ordered. The physician's order specified that metoclopramide 10 mg should be administered orally before meals. However, on the date in question, the medication was documented as given at 07:30 AM, but direct observation showed that the medication was actually administered at 08:45 AM, after the resident had already finished breakfast. The medication administration record, pharmacy label, and facility policy all indicated the medication should be given before meals and within one hour of the scheduled time. Interviews with the DON and the medication aide confirmed that the medication was not given at the correct time, with the aide stating she was unable to administer it before meals due to her medication pass schedule. The DON acknowledged that the medication was late and that all nursing staff had been trained on medication administration times. The facility's policy required medications to be given within one hour before or after the scheduled time, which was not followed in this instance.