Failure to Follow Physician-Ordered Parameters for Pain Medication
Penalty
Summary
A deficiency occurred when a resident with multiple diagnoses, including heart disease, fibromyalgia, hypertension, major depressive disorder, anxiety disorder, a history of pulmonary embolism, breast cancer, muscle weakness, and difficulty walking, was administered Oxycodone-Acetaminophen outside of the physician-ordered parameters. The physician's order specified that the medication should be given every six hours as needed for severe pain rated 7-10 and to be held for lethargy. However, the Medication Administration Record (MAR) showed that the medication was administered on several occasions for pain levels of 3, 5, and 6, which did not meet the criteria outlined in the order. Interviews with facility staff confirmed that the medication was given outside the prescribed parameters. The DON acknowledged that staff should follow physician-ordered parameters for pain medications and recognized that the medication was administered inappropriately. A registered nurse also admitted to administering the medication outside the parameters and not notifying the physician or obtaining a new order. The facility's policy requires medications to be administered as ordered by the provider and in accordance with professional standards, which was not followed in this instance.