cms_WV: 3863
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3863 | PRINCETON CENTER | 515028 | 1924 GLEN WOOD PARK ROAD | PRINCETON | WV | 24740 | 2017-01-19 | 281 | E | 0 | 1 | DBHB11 | Based on record review, policy review, and staff interview, the facility failed to provide services according to accepted standards of clinical practice in regards to medication administration for 39 of 62 residents currently residing in the facility. Two (2) Licensed Practical Nurses (LPN) administering evening and bedtime medications did not sign their names on the Medication Administration Record [REDACTED]. This practice had the potential to affect more than an isolated number of residents. Resident identifiers: #67, #78, #29, #75, #55, #1, #14, #23, #74, #36,#38, #50, #77, #52, #65, #57, #17, #3, #2, #35, #8, #56, #28, #22, #70, #95, #79, #7, #97, #89, #24, #58, #47, #72, #21, #20, #46, #61, and #15. Facility Census: 62. Findings include: On 01/18/17 at 9:30 p.m., the facility was entered to observe evening shift's medication pass. LPN #94 and LPN #95 said all of their medications had been given and there were not any medication passes to be observed at that time. LPN #94 was requested to provide medication administration records (MAR) for residents randomly chosen for review. Upon asking for the MAR for Resident #54, LPN #94 stated she had not yet passed the medications to Resident #54. LPN #94 was told when she did give Resident #54's medications, the surveyor would use that opportunity to observe the medication pass for Resident #54. At 10:04 p.m., while preparing to do the medication pass for Resident #54, LPN #94 said she had not yet signed off on any of the medications she had administered that evening. LPN #94 stated she had started giving medications at 7:00 p.m. and had yet to sign off on any of the medications given. When LPN #94 was asked, When should you sign off on medications? she stated, When I give them. I should sign off and document that they are given as soon as I give them. On 01/18/17 at 10:10 p.m., LPN #95 was asked her if she had signed off on the medications she had given that evening. LPN #95 stated she had not signed the EMAR (electronic medication administration records) at the time the medications were given, and that she was signing off on some of them now. A list of resident's names that had been given medications without LPN #95 signing at the time of dispensing was requested. On 01/18/17 at 10:25 p.m., an interview with the recently acting interim director of nurses, Registered Nurse (RN #109), revealed LPN #95 was a recent hire and LPN #94 had done some training of LPN #95. RN #109 confirmed facility policy and standard of practice dictate nurses sign the EMAR at the time medications are given. The RN verified that not documenting in the EMAR at the time the medications were given would cause the record to be inaccurate for the time the residents received their medication. RN #109 stated disciplinary actions would be taken for both LPN #94 and LPN #95. A list of all residents that had evening and bedtime medications given by LPN #94 and LPN #95, and whose MARs had not been signed by LPN #94 and LPN #95 at the time the medications were given to the residents, was requested. The requested list of residents' names provided on 01/18/17 at 11:03 p.m., revealed LPN #94 gave medications to twenty-nine (29) residents without documenting medications had been given in the EMAR (electronic medication administration record) at the time they were given. LPN #95 gave medications to ten (10) residents without documenting medications had been given in the EMAR at the time they were given. On 01/18/17 at 11:11 p.m., a walk through of the facility to interview any residents identified on the list that might still be awake found Residents #20, #21, and #89 were awake. All three (3) residents stated they did receive their evening and bed time medications. On 01/19/17 at 8:04 a.m., review of facility's policy 6.0 'General Dose Preparation and Medication Administration revealed, #6. After medication administration, facility staff should take all measures required by Facility policy and Applicable Law, including but not limited to the following: 6.1 Document necessary medication administration/treatment information (e.g. when medications are opened, when medications are given .) on appropriate forms. According to Lippincott's 2012 Nursing Drug Handbook, Rights of Medication Administration the 8 rights of medication administration are: 1. Right patient . 2. Right medication . 3. Right dose . 4. Right route . 5. Right time - Check the frequency of the ordered medication. - Double-check that you are giving the ordered dose at the correct time. - Confirm when the last dose was given. 6. Right documentation - Document administration AFTER giving the ordered medication. - Chart the time, route, and any other specific information as necessary. 7. Right reason ., 8. Right response . | 2020-04-01 |