HospitalInspections.org

Based on record review and interview the facility failed to assure that all discharges included a plan to insure availability of appropriate services following hospitalization for one (1) of ten (10) sampled patient discharges. (#2)

Findings:

Record # 2 reflected that the patient was discharged on 05/05/2012 at 5:17 p.m. with a prescription for Clozapine 200 milligrams at bedtime. The record also reflected that the patient's absolute neutrophil count (ANC) on 05/05/2012, the day of discharge was 1.8. The facility policy on dispensing Clozapine documented that for continued therapy the ANC was to be above 2.0.

Interview with the facility pharmacist on 06/14/2012 at 3:15 p.m. confirmed that the policy and National Registry for use of Clozapine required the ANC be above 2.0. She also confirmed no outpatient pharmacy would dispense Clozapine without lab work confirming the ANC was above 2.0.

Interview with the Psychiatrist on 06/14/2012 confirmed that outpatient pharmacy could not dispense Clozapine if the ANC was below 2.0 and he confirmed the patient was given a prescription for Clozapine.