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Based on record review, Physician Review and staff interview the facility failed to honor patients request to have a Zofran (only) continuous infusion for severe diarrhea and nausea and vomiting and administered a Reglan and Zofran continuous infusion resulting in an adverse medication reaction.

Review of facility policy entitled "Pharmacist review of Appropriateness of Medication Orders" (approval date 4/19/17) reveals the pharmacist will review each prescription or order for medication before administration. Exception is made for situations in which a licensed independent practitioner with appropriate clinical privileges controls ordering, preparation and administration of the medication as a cardiac catherization laboratories, surgery, during cardio-respiratory arrest or in Emergency Department. When Questions arise the provider will be contacted for clarifications .... Medications orders entered directly into the CPOE will appear in the pharmacist queue where they are reviewed and verified by a pharmacist prior to being dispensed.
The Pharmacist reviews the medication order and if appropriate will verify the order. The pharmacist will review all medication orders for.. real or potential allergy/sensitivities ...all concerns, issues or questions regarding a medication order will be discussed and clarified with the prescriber before verification.

Review of facility policy entitled "Patients' Rights and Responsibilities" (approval date 6/27/2007) reveals the policy purpose is to ensure the provision of care and treatment in a way that safeguards patients personal dignity and values. To identify patient rights and responsibilities as they relate to the patients experience and response to care.
All patients have the rights and responsibilities concerning their healthcare. All patients have the right to make informed decisions about the medical and health care providers. This includes the right to be informed of their health status, choose who is involved in their case planning or treatment, and request, refuse or withdraw from (to the extent permitted by law) any treatment.
Patients have the right to receive care in a safe environment free from all forms of abuse, neglect or mistreatment .....to participation decisions about care, treatment and services provided, including the right to refuse treatment to the extent permitted by law.

The facility submitted a letter concerning how medical staff handles allergies and and overrides medications that are flagged as alerts to inform prescribers of possible hazards. This letter was presented to State Agency (SA) on July 2, 2019 per Risk Manager (RM). The letter reads "We do not have a specific policy document that addresses how medical staff handles allergies and overrides for the same. When a medical staff member overrides a medication alert, that medical staff member assume responsibility for that override. \