Failure to Ensure Privacy During Blood Glucose Monitoring and Insulin Administration
Penalty
Summary
The deficiency involves the facility’s failure to maintain privacy during blood glucose monitoring and insulin administration for one resident. A nurse (V7, LPN) was observed performing peripheral blood glucose testing and administering 5 units of Humalog (insulin lispro) subcutaneously into the resident’s abdominal area in a hallway near the nursing station, where the resident was visible to other residents and staff. The resident reportedly preferred to have blood sugar checks and insulin injections in the hallway without privacy. The facility’s Medication Pass Guidelines policy, dated 04/19, states that privacy is required for injections and blood glucose monitoring. Review of the resident’s comprehensive care plan with the charge nurse (V8) showed there was no care plan addressing the resident’s stated preference to receive blood glucose monitoring and insulin injections in the hallway without privacy. The charge nurse acknowledged that this preference should have been addressed in the care plan. The resident had diagnoses including hemiplegia and hemiparesis following cerebrovascular disease affecting the left non-dominant side, Type 2 DM, and chronic kidney disease, with active orders for blood glucose monitoring before meals and at bedtime and for scheduled Humalog and Lantus insulin injections. The resident coordinator (V9) stated she was not aware of the resident’s preference and agreed it should be reflected in the comprehensive care plan, and the facility’s care plan policy requires ongoing assessment and revision of care plans based on resident preferences.
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