Failure to Follow PRN Laxative Medication Order
Penalty
Summary
The deficiency involves the facility’s failure to provide pharmaceutical services in accordance with physician orders and its own medication administration policy for one resident. The facility’s policy dated 12/2022 required that medications be administered by licensed nurses or other legally authorized staff as ordered by the physician and in accordance with professional standards of practice. For this resident, the physician’s order dated 3/11/24 specified that Dulcolax 10 mg rectal suppository was to be administered every 24 hours as needed for constipation only if Milk of Magnesia (MOM) was ineffective. Review of the resident’s March 2024 MAR showed that Dulcolax was administered on 3/16/24, but there was no documentation that MOM had been given prior to the suppository as required by the order. In an interview, RN 1 confirmed that Dulcolax was administered on that date and that MOM had not been administered beforehand, acknowledging that the resident should have received MOM first or that a one-time order for Dulcolax should have been obtained. The Administrator and DON were later informed of and acknowledged these findings.
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