Failure to Document PRN Narcotic and Late Administration of Scheduled Medications
Penalty
Summary
The deficiency involves failure to follow professional standards of practice during medication administration and documentation. During an observation, an LPN removed and administered a 5 mg oxycodone tablet to a resident who complained of an upset stomach and headache, signing the narcotic control book when removing the medication from the narcotic drawer. Subsequent medical record review showed the resident had a PRN order for oxycodone 5 mg by mouth every four hours as needed for pain rated 4–6, but the medication administration record (MAR) did not show that the oxycodone dose was documented as administered, despite confirmation in the narcotic book that it had been signed out for that resident. Additional deficiencies were identified during medication pass observations for two other residents when an LPN administered multiple scheduled medications significantly later than the ordered time. For one resident, medications including metformin, Eliquis, aspirin, metoprolol, amlodipine, cetirizine, furosemide, omeprazole, a multivitamin, and fluticasone inhalation were scheduled for 9:00 AM but were administered at 10:30 AM, with the electronic MAR screen highlighted in pink to indicate they were not given at the scheduled time. For another resident, medications and supplements including protein liquid, amlodipine, metoprolol, a multivitamin with minerals, sodium bicarbonate, Vitron-C, and omeprazole were also scheduled for 9:00 AM but were administered at 10:45 AM, again with the computer screen highlighted in pink. The LPN acknowledged in both cases that the medications were given outside the scheduled ordered time and explained she was responsible for two hallways of residents.
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