Failure to Ensure LPN IV Therapy Certification and Documentation
Penalty
Summary
The facility failed to comply with State Law and professional standards regarding intravenous (IV) therapy administration by LPNs. According to Florida regulations, LPNs must complete a minimum 30-hour IV therapy certification course from a Florida Board of Nursing (FBON) approved provider before administering IV medications. Documentation reviewed by surveyors showed that LPNs administered Daptomycin IV to a resident with multiple complex diagnoses, including infection related to a knee prosthesis and MRSA, without evidence of the required IV therapy certification or training. During the survey, the Director of Nursing (DON) and staff were repeatedly asked to provide documentation of IV therapy certification, education, and training for all LPNs, as well as sign-in sheets for infection control and medication administration training. Despite multiple requests over two days, the DON failed to provide the requested documentation or electronic access to resident records. The DON gave conflicting statements, initially indicating that LPNs administered IV therapy, then later stating only RNs performed this task and that LPNs did not require certification. However, Medication Administration Records (MAR) confirmed that LPNs had documented administration of IV medications. Interviews with nursing staff further confirmed that LPNs independently administered IV medications to their assigned residents, and that documentation practices required the nurse who administered the medication to initial the MAR. No evidence was provided to show that LPNs had the necessary IV therapy certification, and the facility was unable to produce policies or training records as requested by the surveyor. The lack of documentation and inconsistent responses from facility leadership contributed to the identified deficiency.