Late IV Antibiotic Administration and Missing Care Plan for PICC Therapy
Penalty
Summary
The deficiency involves the facility’s failure to administer an IV antibiotic according to the physician’s order and to incorporate the resident’s IV therapy into the care plan. A resident admitted with diagnoses including abscess of the spleen, chronic viral hepatitis C, and peritoneal abscess had a physician’s order for Cubicin (daptomycin) 350 mg IV once daily at 9:30 a.m. for an abdominal abscess, with an active order through 03/24/26. The resident also had a left arm PICC/midline with orders to monitor for leaking and signs and symptoms of infection every shift. Record review showed that the resident’s care plan contained no documentation, goals, or interventions related to the IV medication therapy for the active infection, nor for the maintenance, use, or observation of the PICC line. Review of the medication administration record revealed that the Cubicin dose scheduled for 9:30 a.m. on 02/27/26 was not administered until 3:20 p.m., six hours late, by an LPN. In interview, the LPN stated that on that date she was the only nurse administering medications to nearly 70 residents and that medications, including this resident’s Cubicin, were given late. The Regional Director of Clinical Operations confirmed that the IV antibiotic was documented as administered six hours after the scheduled time. Facility policy on medication therapy stated that each resident’s medication regimen shall include only those medications necessary to treat existing conditions and that medication-related issues shall be reviewed as part of quality assurance activities. This situation was cited as a deficiency under the referenced master complaint number.
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