Failure to Hold Blood Pressure Medication per Physician Parameters
Penalty
Summary
The facility failed to follow physician-ordered parameters for administering blood pressure medication to a resident diagnosed with orthostatic hypotension, vertigo, depression, and nonrheumatic aortic valve stenosis. The physician's order specified that midodrine should be held if the resident's blood pressure exceeded 140/85 mmHg. However, the Medication Administration Records (MAR) for July, August, and September documented multiple instances where the resident received midodrine despite blood pressure readings above the ordered threshold. These instances were confirmed by a licensed nurse, who verified that the medication was not held as directed by the physician's order. The resident's care plan identified her as being at risk for adverse reactions due to her medication regimen and directed staff to monitor for side effects and administer medications as ordered. The facility's policy required staff to check and verify vital signs before administering medications when necessary. Despite these directives, staff administered midodrine outside of the prescribed parameters on several occasions, as evidenced by the MAR and staff interviews.