Failure to Timely Administer Prescribed Pain Medication
Penalty
Summary
The facility failed to ensure that a resident's physician orders for pain management were followed and that care-planned interventions were implemented to provide timely administration of pain medication. The resident, who was newly admitted with diagnoses including type 2 diabetes mellitus with diabetic neuropathy, chronic pain syndrome, and restless leg syndrome, had physician orders for pregabalin twice daily and hydrocodone-acetaminophen (Norco) every six hours as needed for moderate to severe pain. Upon admission, the resident did not have prescriptions for these medications sent to the pharmacy, resulting in their unavailability. During the period following admission, the resident experienced frequent and significant pain, with pain levels reported as high as eight out of ten, which affected sleep and participation in therapy. Nursing staff attempted to obtain the necessary prescriptions by contacting the nurse practitioner and pharmacy, but there was a delay in communication and follow-through. As a result, the resident was only provided with alternative pain relief measures such as acetaminophen and topical Biofreeze, which were not the medications ordered by the physician for the resident's chronic and severe pain. Interviews with nursing staff and the DON revealed that the nurses were responsible for ensuring prescriptions were in place but did not successfully obtain them in a timely manner. The nurse practitioner confirmed that she was not informed that prescriptions were needed until the following day. This lapse led to the resident not receiving the prescribed pain medications as ordered, and the care plan interventions for pain management were not fully implemented.