Failure to Follow Physician Orders for Antihypertensive Medication Administration
Penalty
Summary
Nursing staff failed to administer a prescribed antihypertensive medication, Norvasc (Amlodipine Besylate), in accordance with physician orders and facility policy for a resident with multiple cardiac and respiratory diagnoses, including congestive heart failure, respiratory failure with hypoxia, atherosclerotic heart disease, and hypertension. The physician's order specified that the medication should be held if the resident's systolic blood pressure was less than 120 mm/Hg. Despite this, clinical record review showed that the medication was administered on at least 30 occasions when the resident's systolic blood pressure was below the ordered threshold. Facility policy required staff to verify medication allergies and obtain vital signs prior to medication administration, and state nursing standards mandate that licensed nurses provide care in accordance with professional standards and maintain accurate records. Documentation revealed that the medication was repeatedly given outside the prescribed parameters, and this was confirmed by the Nursing Home Administrator during an interview. The failure to follow physician orders and professional standards resulted in multiple medication administration errors for the resident.