| 1051 |
AURORA SENIOR LIVING OF DERRY, LLC |
305095 |
20 CHESTER ROAD |
DERRY |
NH |
3038 |
2015-04-16 |
281 |
D |
0 |
1 |
MSZZ11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, it was determined that the facility failed to meet professional standards of quality for 2 out of a sample of 15 residents. (Resident identifiers are #3 and #5). Findings include: The Potter-Perry, 2009, Review of Fundamentals of Nursing, Patricia A. Potter and Anne Griffin Perry, Mosby, St. Louis, Missouri, 2009, 7th Edition, revealed the following, Chapter 23 Legal Implications in Nursing Practice, on page 336- Physicians' Orders states, The physician is responsible for directing medical treatment. Nurses follow physician's orders [REDACTED]. Therefore you need to assess all orders, and if you find one to be erroneous or harmful, further clarification from the physician is necessary . Patricia A. Potter and Anne Griffin Perry, Fundamentals of Nursing, 7th Edition, St. Louis, Missouri: Mosby Elsevier, 2009, on page 699 relates Prescribers must document the diagnosis, condition, or need for use for each medication ordered and on page 708 The prescriber often gives specific instructions about when to administer a medication Resident #3: Record review revealed PRN (as needed) orders dated for April of 2015 as follows: [MEDICATION NAME] PO (Tylenol Oral tab) Give 650 by mouth every 4 hours as needed (PRN) pain/fever. [MEDICATION NAME] HCL tablet 50 mg; Give 50 mg by mouth every 6 hours as needed for pain. Resident #5: Record review revealed PRN (as needed) orders dated for April 2015 as follows: [MEDICATION NAME] PO (by mouth) 650 mg; Take 650 mg by mouth every 4 hours as needed for pain/fever. [MEDICATION NAME]-[MEDICATION NAME] tablet 5-325mg; Give 1 tablet by mouth every 4 hours as needed for pain. There are no parameters or indications for when to give each of these medications, or any record of attempt to clarify the orders. In addition, Resident #5 has the following transcription error in her Medication Administration Record: [REDACTED] [MEDICATION NAME] Gel 1mg % GEL; give 1 ml by mouth (PO) at bedtime for agitation/anxiety 1 ml=1mg. [MEDICATION NAME] Gel 1mg % GEL; Give 0.5 ml by mouth every 6 hours as needed for agitation/anxiety 0.5ml=0.5mg. There are 14 entries whereby this medication was signed off as given as per current order between 4/1/15 and 4/14/15. There is no record of attempts to clarify these orders. Interview with Staff A, (DON) Director of Nursing by telephone on 4/17/15 at 11:35 am revealed that the [MEDICATION NAME] orders on the MAR (Medication Administration Record) were in error, and should have indicated that the [MEDICATION NAME] was to be applied topically, and this resident only gets the [MEDICATION NAME] topically. |
2018-05-01 |