cms_AK: 62
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 62 | WRANGELL MEDICAL CENTER LTC | 25015 | P.O. BOX 1081 | WRANGELL | AK | 99929 | 2018-04-30 | 658 | D | 0 | 1 | O8F911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observation and interview the facility failed to follow professional standards for nursing during medication administration for 3 residents (#s 7, 10 and 11) during 4 of 4 observations. This failure to administer medications correctly can result in residents receiving more medication than ordered and/or not taking their medications as prescribed. Findings: Resident #7 Record review on 4/23-27/18, revealed Resident #7 was admitted to the facility with a [DIAGNOSES REDACTED]. During an observation on 4/24/18 at 8:58 am, Licensed Nurse (LN) #1 performed medication administration at Resident #7's bedside. The LN gave Resident #7 his/her [MEDICATION NAME] bottle to self-administer the medication. Resident #7 was observed to self-administer 2 sprays in each nostril. LN #1 did not correct this dosing error or provide education. Observation on 4/24/18 at 12:06 pm, revealed Resident #7 had a bottle of multi vitamins on his/her bedside table. During an interview on 4/24/18 at 12:06 pm, Resident #7 stated he/she took the vitamins daily without notifying any staff. Review of Resident #7's physician orders [REDACTED]. Review of Resident #7's medical record revealed no form of self-administration assessment documentation approved by the Interdisciplinary Team (IDT). Resident #10 Record review on 4/23-27/18, revealed Resident #10 was admitted to facility with [DIAGNOSES REDACTED]. During an observation on 4/24/18 at 8:10 am, LN #1 performed medication administration with Resident #10. The LN placed a cup of pills next to Resident #10 and walked away without observing Resident #10 taking the mediation. During an observation on 4/25/18 at 7:18 am, LN #1 performed medication administration at Resident #10's bedside. He/she gave Resident #10 his/her [MEDICATION NAME] bottle to self-administer his/her medication: [MEDICATION NAME] 50mcg 1 spray both nares. Resident was observed to self-administer 2 sprays in each nostril. LN #1 did not correct this dosing error. During an interview on 4/27/18 at 1:42pm, LN #1 stated he/she should not have left the medications at Resident #10's table without ensuring all medications were taken. In addition, the LN stated he/she was not able to guarantee Resident #10 took all of his/her medication during the medication administration on 4/24/18. Furthermore, LN #1 stated the administration of 2 sprays of the medication [MEDICATION NAME] did not meet the provider's order and should have been corrected at the time of administration. Review of Resident #10's physician orders [REDACTED]. - [MEDICATION NAME] SUCC (treats high blood pressure) ER 50mg by mouth daily - Multivitamin Daily Vite (nutritional supplement) by mouth daily - [MEDICATION NAME] (treats high blood pressure and heart failure) 10mg by mouth daily - Aspirin EC (blood thinner, reduces risk of [MEDICAL CONDITION]) 81mg by mouth daily - Tylenol (fever/pain reliever) 500mg by mouth twice a day - [MEDICATION NAME] (treats/prevents heartburn) 150mg by mouth daily - [MEDICATION NAME] DN (prevents chest pain) 20mg by mouth twice a day - [MEDICATION NAME] (treats high blood pressure) 25mg by mouth 2 tabs daily - Folic Acid (treats [MEDICAL CONDITION]) 1mg by mouth daily - [MEDICATION NAME] (nasal spray for allergy relief) 50mcg, 1 spray both nares. Review of Lippincott's document entitled 8 Rights of Medication Administration, dated 2011, revealed to ensure a healthcare professional is to ensure they are administering the correct dose in conjunction with the provider's order. Resident #11 Review of the most recent MDS (Minimum date Set) assessment, a quarterly assessment dated [DATE], revealed Resident #11 was coded as having minimal difficulty hearing; clear speech; ability to make self understood; and usually understands others. Observation on 4/26/18 at 8:55 am, revealed LN #2 administering Resident #11 his/her morning medication. Resident #11 asked LN #2 three different times, What are these pills? LN #2 replied each time by saying, It's your morning meds. LN #2 did not offer to explain the medications to Resident #7 during medication administration. During an interview on 4/26/18 at 3:00 pm, LN #2 was asked what the process was when a resident asked about medications he/she was taking. In response, the LN stated, I'll just sit down and talk to them about it. When asked about the morning medication pass on 4/26/18 with Resident #11, LN #2 stated he/she should have taken the opportunity to explain the medications to him/her. Review of Lippincott's document entitled Medication Safety: Go Beyond the Basics, dated (YEAR), revealed the healthcare professional should educate patients about their medications. During an interview on 4/26/18, the Chief Nursing Officers stated the facility used Lippincott as their professional reference. Review of Wrangell Medical Center's Resident's Bill of Rights, undated, revealed, Resident has the right to participate in the development and implementation of his or her person-centered plan of care, including to identify individuals or roles to be included in the planning process; to request meetings and the right to request revisions to the plan of care; to identify the expected goals and outcomes of care; and to identify the type, amount, frequency, and duration of care, among other factors. | 2020-09-01 |