Failure to Follow Medication Administration Parameters
Penalty
Summary
A deficiency occurred when a Licensed Vocational Nurse (LVN) failed to follow a physician's ordered parameters for administering valsartan to a resident with diagnoses including essential hypertension, osteoarthritis, and hyperlipidemia. The physician's order specified that valsartan should be withheld if the resident's systolic blood pressure was less than 110 mmHg or if the heart rate was less than 60 beats per minute. The LVN initially checked the resident's blood pressure and heart rate approximately 30 minutes before attempting to administer the medication, but the resident refused the medication at that time. The LVN then labeled the prepared medication and stored it in the locked medication cart. Later, the LVN administered the previously prepared crushed medications mixed with applesauce to the resident without reassessing the resident's vital signs immediately prior to administration, as required by the physician's order. The facility's policies indicated that medications must be administered in accordance with prescriber orders and that a medication error includes any administration not in accordance with such orders. The Director of Nursing confirmed that parameters such as blood pressure and heart rate must be checked immediately before medication administration to avoid adverse effects.