Delayed Administration of Physician-Ordered Antibiotic
Penalty
Summary
Facility staff failed to administer a physician-ordered antibiotic to a medically compromised resident in a timely manner. The resident, who had multiple pressure injuries, Type 2 Diabetes Mellitus, severe protein-calorie malnutrition, and hemiplegia/hemiparesis following a cerebral infarction, developed a reddened and swollen genital area that was tender to touch. The on-call Nurse Practitioner was notified and ordered Levofloxacin 500 mg daily for 10 days, with instructions for the resident to be seen the following day. Although the antibiotic was available in the facility's emergency medical supply, the first dose was not given until 14 hours after the order was received. Review of documentation and interviews revealed that the Nursing Supervisor on duty entered the order into the Medication Administration Record (MAR) but scheduled the first dose for the following morning, believing that was the correct procedure. Both the physician and the Director of Nursing later confirmed that the first dose should have been administered the evening the order was received. Facility policy required all administered medications to be documented in the resident's medical record, and the delay in administration was not consistent with this policy.