cms_ND: 67
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 67 | MINOT HEALTH AND REHAB, LLC | 355031 | 600 S MAIN ST | MINOT | ND | 58701 | 2017-07-26 | 281 | D | 0 | 1 | GH6U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** MEDICATION VIA GASTROSTOMY TUBE 1. Based on observation, record review, review of facility policy, and staff interview, facility staff failed to provide care and services according to professional standards for 1 of 1 sampled resident (Resident #8) observed receiving medications via gastrostomy ([DEVICE]). Failure to flush the [DEVICE] between medications may affect the efficacy of the medications. Findings include: Review of the facility policy titled, Administering Medications through an Enteral Tube occurred on 07/26/17. This policy, not dated, stated, . Equipment and Supplies . 26. If administering more than one medication, flush with 15 ml (milliliters) (or prescribed amount) warm sterile or purified water between medications. Review of Resident #8's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. Liquid medications included [MEDICATION NAME] (laxative) and UTI (Urinary Tract Infection) Heal (cranberry supplement). Observation on 07/25/17 at 9:20 a.m. showed a licensed staff nurse (#7) checked placement of Resident #8's [DEVICE] and administered [MEDICATION NAME] mixed in 120 cubic centimeters (cc) of water, and without flushing the [DEVICE] with water, the nurse administered the UTI Heal mixed in 120 cc of water. During an interview on 07/26/17 at 11:00 a.m., an administrative nurse (#3) stated she would expect staff to flush the [DEVICE] with water between medications. INSULIN ADMINISTRATION 2. Based on observation and review of professional reference, the facility failed to follow professional standards of practice regarding insulin administration for 1 of 3 residents (Resident #7) observed receiving rapid-acting insulin. Failure to ensure food is offered within the recommended time frame after insulin administration may result in [DIAGNOSES REDACTED] (low blood sugar). Findings include: The Nursing (YEAR) Drug Handbook, 37th Edition, Wolters Kluwer, Pennsylvania, pages 789-790 stated, . [MEDICATION NAME] . (5 to 10 minutes) before a meal. Observation on 07/24/17 at 5:25 p.m. showed a licensed staff nurse (#7) administered 4 units of [MEDICATION NAME]to Resident #7. Resident #7 sat at the dining room table with only a glass of water until 6:02 p.m. when he received his meal tray (37 minutes later). MEDICATION TRANSCRIPTION 3. Based on observation, record review, review of facility policy and review of professional reference, the facility failed to ensure accurate transcription of medication orders for 1 of 13 sampled residents (Resident #6). Failure to ensure the medication administration record (MAR) and medication label contain the same information as the physician's order may lead to medication errors. Findings include: Berman and Snyder, Kozier & Erb's Fundamentals of Nursing Concepts, Process, and Practice, 10th ed., Pearson Education Inc., New Jersey, page 761, stated, . Communicating a Medication Order . A drug order is written on the client's chart by a primary care provider or by a nurse receiving a telephone or verbal order from a primary care provider. The nurse or clerk then copies the medication order to a Kardex or medication administration record (MAR). CLINICAL ALERT . If your assigned client receives new medication orders, double-check the transcribed information with the primary care provider's order. This ensures client safety. Review of the facility policy titled Labeling of Medication Containers occurred on 07/26/17. This policy, revised (MONTH) 2007, stated, . Any medication packaging or containers that are inadequately or improperly labeled shall be returned to the issuing pharmacy. The nursing staff must inform the pharmacy of any changes in physician orders for a medication. Review of Resident #6's medical record occurred on all days of survey. A physician's order, dated 07/21/17, stated, [MEDICATION NAME] (a pain reliever) 5 mg (milligrams) - 325 mg oral tablet . Instructions: 0.5 (one half) tab (tablet) q8h (every eight hours) PRN (as needed) for severe pain. Review of Resident #6's (MONTH) MAR showed a hand written entry, dated 07/22/17, that identified [MEDICATION NAME] 5 mg - 325 mg every eight hours for severe pain. The MAR failed to identify the correct dose of half a tablet. Observation of the medication cart on the afternoon of 07/25/17 showed Resident #6's [MEDICATION NAME] contained a label on the package which identified the frequency as twice per day, not every eight hours as ordered on [DATE]. Failure to ensure the MAR and medication label accurately reflect the physician's order may result in medication errors. | 2020-09-01 |