cms_GA: 4939
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4939 | PRUITTHEALTH - VALDOSTA | 115377 | 2501 NORTH ASHLEY STREET | VALDOSTA | GA | 31602 | 2016-03-03 | 309 | D | 1 | 0 | 7KN011 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on medical record and staff interview, the facility failed to administer the correct dosage of [MEDICATION NAME] per Physician the order for one (1) resident R7 of three (3) sampled residents. Findings include: Review of medical records for resident R7 who was admitted to the facility under Hospice services on 12/3/15 with [DIAGNOSES REDACTED]. Review of the Resident R7 had a Physician order [REDACTED]. Review of the Nurse ' s Note dated 12/10/15 revealed resident R7 received [MEDICATION NAME] 4 mg IM one dose related to increase agitation. Further review of the nurse ' s note for behavior revealed five (5) episode of agitation or restlessness noted in (MONTH) (YEAR). In (MONTH) (YEAR) resident #7 was noted to have two (2) episode of being sedated. During an interview on 3/2/16 at 9:26 a.m. with BB Registered Nurse (RN) was asked by nurse surveyor to read his/her nurse's note dated 12/10/15. BB RN stated resident R7 was administered [MEDICATION NAME] 4 mg IM and verified that it charted in the nurse' s notes. BB RN stated three (3) separate times that [MEDICATION NAME] 4 mg was administered to resident R7. BB RN was asked to review the Physician order [REDACTED]. After BB reviewed the Physician order, BB stated that he/she had made a mistake and gave resident R7 the wrong dose of [MEDICATION NAME]. During an interview on 3/2/16 at 10:32 a.m. with CC RN revealed that the [MEDICATION NAME] 2 mg as needed was changed on 12/10/16 because the facility staff nurse reported that resident R7 was trying to bed out of bed, had increase restlessness and was pulling at things. CC RN stated he/she obtained the new Physician order [REDACTED]. However, CC RN then stated he/she was not aware of the 12/3/15 Physician order [REDACTED]. During an interview via phone on 3/2/16 at 3:21 p.m. with FF Advanced Nurse Reactionary (ANP) stated resident R7 was exhibiting increased anxiety with [MEDICATION NAME]. Therefore scheduled [MEDICATION NAME] ([MEDICATION NAME]) 1 mg tablet by mouth four (4) times daily and that resident R7 would take [MEDICATION NAME] 1 mg tablet every six (6) hours to manage his agitation and restlessness. FF ANP stated that she/he was not aware of the medication error for the [MEDICATION NAME] on resident R7. During an interview via phone on 3/2/16 at 3:55 p.m. the Pharmacist stated that six vials of [MEDICATION NAME] 5mg/1ml had been sent to the facility on [DATE] and resident R7 was to receive 2mg IM as needed. During an interview on 3/2/16 at 3:58 p.m. with Director of Nursing (DON) she stated that nurses are expected to follow a Physician order [REDACTED]. | 2019-03-01 |