Failure to Follow Medication Administration Parameters for Cardiovascular Residents
Penalty
Summary
The facility failed to follow physician-ordered medication administration parameters for two residents with cardiovascular conditions. For one resident diagnosed with hypertension and heart failure, the care plan required administration of Metoprolol Tartrate with instructions to hold the medication if the systolic blood pressure was less than 110. Despite this, the medication was administered on multiple occasions when the resident's systolic blood pressure was below the specified threshold, including readings of 104 and 90. Staff confirmed during interview that medications should not be given if vital signs are outside of ordered parameters. Similarly, another resident with cerebrovascular disease and hypertension had a physician's order for Metoprolol Succinate Extended Release, to be held if the heart rate was less than 60. The medication administration records showed that the medication was given on several dates when the resident's heart rate was below 60, with documented rates as low as 53. The facility's policy required medications to be administered in accordance with accepted standards of practice, which was not followed in these instances.