F0726

F

Failure to Ensure LPN IV Certification and Proper Administration of IV Antibiotics

Saint Petersburg, Florida Survey Completed on 03-03-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to ensure that LPNs had the required IV therapy certification and documented competency to administer IV medications, including through PICC (a type of central venous catheter), for multiple residents. Florida Board of Nursing requirements cited in the report specify that LPNs may perform IV therapy only after appropriate education and training, including a minimum of four hours of instruction with didactic and clinical components, and facility-determined competency. Despite these requirements, several LPNs either lacked IV certification, had not provided proof of certification, or had incomplete documentation of their IV training while still being associated with residents receiving IV antibiotics.

For one resident with an infected left foot and a PICC line, physician orders included Cefepime IV every 12 hours for several weeks and Vancomycin IV once daily. The MAR showed multiple IV antibiotic administrations documented by various LPNs, including entries by LPNs later identified as not IV certified or unable to produce IV certification (e.g., Staff B, C, E, J, L, and others). Interviews revealed that one LPN assigned to this resident stated she was new, had not provided her IV course certificate, and could not administer the ordered IV antibiotic; the ADON also stated she did not have an IV certificate in Florida and that the DON would administer the IV antibiotic. Another LPN reported she had taken an IV course a year prior but never received a certificate and would need to contact the organization that provided the course, despite having been employed at the facility for nearly a year.

For another resident with wound infection requiring Vancomycin IV and a third resident with osteomyelitis requiring Cefazolin IV three times daily, physician orders and MARs showed multiple IV antibiotic administrations documented by LPNs whose IV certification status was not verified or was explicitly reported as lacking. The MAR for the resident with Vancomycin showed several IV doses signed out by different LPNs, and the MAR for the resident with Cefazolin showed numerous IV doses documented by multiple LPNs, including agency staff. During an interview, facility leadership confirmed that one resident had not received a scheduled morning dose of Cefazolin, even though the next dose was already scheduled for later that day. Overall, observations, interviews, and record review demonstrated that the facility did not ensure LPNs administering IV medications, including via PICC lines, were appropriately IV certified and that IV therapy was administered as ordered.