HospitalInspections.org
Bringing transparency to federal inspections
HOUSTON METHODIST CLEAR LAKE HOSPITAL
ADMINISTRATION OF DRUGS
Tag No.: A0405
Based on observation, interview and record review the facility failed to ensure medication were administered in two (2) out of five (5) sampled patients per facility policy .
Findings include:
These two patients ID #3 and #6 were not wearing Allergy ID bands. Nursing had administered medications to these patients shortly before the observation per the MAR (medical administratin record).
Observed on 6/28/18 between 10:00 am-11:000 am during facillity tour , Patient ID #3 was interviewed by Surveyor and at that time it was observed the Patient #3 did not have RED ALLERGY ID Band on wrist, asked if she received her morning medications she responded , "yes".. Patient ID # 6 had alos been observed not wearing RED ALLERGY ID Band on wrist. Patient #6 asked if she received her morning medications, responded, "yes".
Interview on 6/28/18 at time of both incidents with Director ID# 53 revealed that she observed the ALLERGY ID Bandswere not on (2) of the (5) patients the Survetor interviewd, and sated, "that is not aceptable practice".
Record review of Patient #3 MAR ( medical record) revealed Patient #3 had documented ALLERGY to Atorvastatin, Cephalexin. Patient #6 had documented in MAR, Darvon and Morphine. Both patients had documented in Nursing flowsheet wearing ID bands.
Record review of facility policy, titled" Color Coded Wristband Alerts, dated, 01/2017 read:
POLICY:
In order to maintain patient safety and comply with regulatory requirements, Houston Methodist will use standardized, specific-colored wrist band alerts as patients may be transferred between healthcare facilities and healthcare staff members work multiple facilities thus standardization minimizes confusion and promotes patient safety.
Wristband alerts are an additional visual cue meant to enhance patient safety ...
Definitions:
RED = ALLERGY A red wristband alert will be placed on any patient with a history of allergies. All allergies, including latex, will be documented in the medical record at all Houston Methodist hospitals ...