Failure to Administer Physician-Ordered Medications for Itching
Penalty
Summary
The facility failed to administer medications as ordered by physicians for two residents with documented skin conditions and persistent itching. One resident, with diagnoses including hypertension, COPD, and urinary retention, developed a generalized rash with excoriations and was observed repeatedly scratching, resulting in blood-stained bedding. Despite a physician's order for hydroxyzine HCL to be given every eight hours as needed for itching, the medication was not administered for several days. Staff interviews confirmed awareness of the resident's ongoing itching and the failure to provide the ordered medication. Another resident, diagnosed with a rash, COPD, and depression, also experienced persistent itching and visible rashes on multiple body areas. This resident had physician orders for hydrocortisone cream and hydroxyzine HCL for itching, but the oral medication was not administered as ordered over several days. The resident reported that staff did nothing to help with the itching, and staff interviews, as well as observations, confirmed the lack of medication administration. The Director of Nursing and Nursing Home Administrator acknowledged the failure to provide medications as ordered for both residents.