HospitalInspections.org

Based on document review and interview it was determined the facility failed to ensure drugs and biologicals were administered on the orders of a licensed practitioner authorized by the facility to order medications in one (1) of one (1) incidents reviewed to have no order for medications that were administered at the facility. This failure to ensure medication administration only on authorized practitioner orders has the potential to impact all care at the facility by the potential for improper administration of medications.

Findings include:

1. A review of the self-reporting document sent in to the State of West Virginia Board of Examiners for Registered Professional Nurses by Registered Nurse (RN) #1 revealed the RN stated she was employed at the facility. She wrote: "with my nursing knowledge of lidocaine...I knew [my daughter] had no allergy to lidocaine". She further stated that she gathered a 0.2 mililiter (ml) dose of lidocaine, an insulin syringe, and two (2) or three (3) alcohol swabs and gave her the 0.2 [ml] of lidocaine right under the brown area on her daughter's side.

2. A review of the facility policy entitled 'Medication Orders' last revised 6/13 revealed as stated: "POLICY: 1. Medications are prepared and administered only on the order of a licensed practitioner authorized by the hospital to order medications...".

3. An interview was conducted with the Chief Nursing Officer (CNO) on 9/19/16 at about 1:46 p.m. and the above document and her subsequent investigation and discussion with RN #1 were reviewed. She confirmed when she interviewed RN #1 the nurse admitted she had injected her child with lidocaine without a physician's order. The CNO further stated that RN #1 had gone on sick leave and was not available for an interview.