Failure to Administer Insulin as Ordered
Penalty
Summary
A deficiency occurred when a nurse failed to administer Insulin Glargine as prescribed to a male resident with vascular dementia, type 2 diabetes, and major depressive disorder. The resident's care plan required administration of medications as ordered, and physician orders specified a daily dose of Insulin Glargine. However, the medication administration record showed that several doses were held on specific dates, with documentation stating they were held per physician orders, despite no such orders being present in the resident's medical record for those months. The nurse responsible for holding the insulin doses stated she did so out of concern for potential hypoglycemia when the resident refused breakfast, but she did not document her reasoning in the progress notes. She later acknowledged that Insulin Glargine is a long-acting insulin and should not have been held without a physician's order. The Director of Nursing confirmed that licensed nurses are expected to follow physician orders regarding insulin administration.