Medication Administration and Insulin Sliding Scale Deficiencies
Penalty
Summary
Facility staff failed to obtain and administer medications according to procedures for two residents. For one resident, multiple medications, including Famotidine, Levothyroxine, and a nasal solution, were not administered as ordered because the pharmacy had not delivered them to the facility. Documentation in the Medication Administration Record (MAR) indicated these medications were coded as not given, with progress notes confirming the medications were ordered but unavailable. The facility's policy required medications to be administered within appropriate time frames, but this was not followed in these instances. In another case, staff did not accurately or safely conduct and apply the insulin sliding scale before meals for a resident with diabetes mellitus type 2. The nurse failed to perform a blood sugar (BS) check before breakfast and did not provide the correct insulin coverage, as the MAR had an incorrect time for the BS check that did not align with the actual meal time. The night shift nurse performed a BS check much earlier than the meal and administered insulin based on that reading, while the day shift nurse omitted the required pre-meal BS check and insulin coverage. These actions resulted in the resident not receiving insulin as ordered in relation to meal times.