Failure to Monitor for Adverse Effects of Reglan
Penalty
Summary
The facility failed to ensure appropriate monitoring for adverse effects of the medication Reglan (Metoclopramide HCl) for a resident with diagnoses including congestive heart failure, diabetes mellitus, and gastroesophageal reflux. The resident's medical record documented the use of multiple medications, including insulin, a diuretic, and an antidepressant, and indicated intact cognition. The care plan specified that medications would be administered as ordered and that the resident would be monitored for side effects, with documentation of effectiveness. Despite a physician's order for Reglan to be administered before meals for nausea, the facility was unable to provide evidence of an Abnormal Involuntary Movement Scale (AIMS) test or any other method of monitoring for side effects related to this medication. Staff interviews revealed that AIMS testing was not triggered for this resident because Reglan was not classified as a psychotropic medication in the facility's system. Additionally, the facility could not provide a policy related to monitoring medication side effects when requested.