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OSF LITTLE COMPANY OF MARY MEDICAL CENTER
ADMINISTRATION OF DRUGS
Tag No.: A0405
Based on document review and interview, it was determined for 2 of 3 (Pt #2 and 10) clinical records reviewed of patients receiving an anticoagulant, the Hospital failed to ensure the medication was administered as required.
Findings include:
1 The clinical record of Pt #2 was reviewed on 9/6/16 at approximately 11:00 AM. Pt #2 was a 53 year old male admitted 8/14/16 with a diagnosis of morbid obesity. Pt #2's clinical record contained a physician's order dated 8/29/16 that required, "Lovenox 40 mg (milligram) SQ (subcutaneous) daily." Pt #2's clinical record contained documentation that the medication was administered in the patients arm: 9/3 RTA (right arm); 9/4 LTA (left arm); 9/5 RTA; and 9/6/16 LTA.
2. The clinical record of Pt #10 was reviewed on 9/6/16 at approximately 12:45 PM. Pt #10 was an 82 year old female admitted on 9/3/16 with a diagnosis of bowel obstruction. Pt #10's clinical record contained a physician's order dated 9/4/16 that required, "Lovenox 30 mg SQ daily. Pt #10's clinical record contained documentation that on 9/4 and 9/5/16 the Lovenox was administered in the left abdomen and not alternated as required and on 9/6/16 the medication was administered into Pt #10's left arm.
3. The Outcomes Coordinator and 7 West Unit Manager stated during interviews on 9/6/16 at approximately 11:10 AM and 12:45 PM that Lovenox should not be administered in the arms or legs.
4. Hospital in-service poster entitled, "Giving Lovenox? Think Love-Handles," located on 7 West (undated) included, "...It should be given in the abdominal wall... the area known as the 'love handles' which is roughly 2-3 inches to the right or left to the umbilicus...Document ABDOMEN as the site...but add ANT LAT or POST LAT (R) or (L) as a comment if you can."
5. The drug insert for enoxaparin sodium (Lovenox) injection dated 2014 was reviewed on 9/6/16 at approximately 1:30 PM. The insert indicated, "...2.4 Administration...Enoxaparin sodium must not be administered by intramuscular injection...Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall."