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ORLANDO HEALTH ORLANDO REGIONAL MEDICAL CENTER
ADMINISTRATION OF DRUGS
Tag No.: A0405
Based on interview, record review and a review of facility documentation, the facility failed to ensure that drugs were administered in accordance with approved policies and procedures for 1 of 10 sampled patients (#1).
Findings:
Patient #1's "ED (Emergency Department) Adult Trauma Flowsheet" indicated that the patient arrived in the Emergency Room at 9:55 PM on 5/12/16.
Topiramate had been ordered on 5/13/16 at 1:27 AM specifically as: "Topiramate (same as Topamax) give 200 MG (milligrams) PO (by mouth) 2 times a day." The record revealed that it had been given on 5/13/16 only at 2:02 AM. There was no evidence that a second administration had taken place. "Topamax is used to prevent seizures in adults and children and to prevent migraine headaches." (drugs.com).
A review of facility policy "Medication Scheduling" revealed that two-times-a day medications should be given at 9 AM and 9 PM and that "Routine medication orders are administered within 120 minutes after receipt of the order." The record revealed that a dose was given at South Seminole Hospital, after a 9:15 PM transfer, at 12:20 AM on 5/14/16. This was beyond the accepted time frame.
Ativan had been ordered on 5/13/16 at 1:27 AM specifically as: "Lorazepam oral (same as Ativan) give 2 MG PO 3 times per day." The record revealed that it had been given on 5/13/16 at the following times as part of a normal schedule: 10:46 AM and 3 PM. There was no evidence that the third administration had been given. "Lorazepam is used to treat anxiety." (mayoclinic.org).
A review of facility policy "Medication Scheduling" revealed that three-times-a day medications should be given at 9 AM, 3 PM and 9 PM and that "Routine medication orders are administered within 120 minutes after receipt of the order." The record revealed that a dose was given at South Seminole Hospital, after a transfer, at 12:20 AM on 5/14/16. This was beyond the accepted time frame. Thus, the facility was not in compliance with the policy.
During an interview of the Risk Manager at approximately 4:15 PM on 6/30/16, she confirmed the findings.