Unauthorized Medication Administration and Unclear Physician Order for Lidocaine Patch
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) who was not authorized to administer medications applied two Lidocaine patches to a resident during morning care. The medication aide (MA) provided the patches to the CNA, instructing her to apply them while the resident was receiving peri care, as the MA was occupied dispensing medications to another resident. The CNA applied one patch to the resident's right hip and a second patch to the left thigh, despite not being trained or authorized to administer medications. The MA later acknowledged that it was not facility policy for CNAs to apply medication patches and that only medication aides and nurses were responsible for this task. The physician's order for the resident specified the application of a Lidocaine patch to the hip once daily for pain, but did not clarify which hip. The MA and the Director of Nursing (DON) both noted the lack of clarity in the order, with the DON stating that the order should have been clarified and that only one patch was expected to be applied. The physician was also unsure whether the patch was intended for one or both hips and indicated the need to clarify the order. The MA did not report the discrepancy in the order at the time of the incident. The facility's policies and job descriptions specify that only authorized staff, such as medication aides and nurses, are permitted to administer medications, and that CNAs are not trained or authorized to do so. The DON confirmed that the CNA had not been trained in medication administration and would not have known the rights of administration. The incident was considered a medication error, as the administration of the Lidocaine patches was not in accordance with the provider's order or facility policy.