The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

OSCEOLA REGIONAL MEDICAL CENTER 700 WEST OAK STREET KISSIMMEE, FL 34741 Nov. 15, 2012
VIOLATION: ADMINISTRATION OF DRUGS Tag No: A0405
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


Based on interview and record review, the facility failed to ensure that drugs which belonged to the patient and were allowed for use were administered in accordance with the orders of the practitioner responsible for the patient's care, accepted standards of practice, Federal law and approved policies and procedures for 1 of 10 sampled patients (#1)

Findings:

A review of the medical record of patient #1 was performed. The patient was admitted to the Clinical Decision Unit of the hospital at 01:51 AM on 9/21/12. Physician orders of 9/21/12 at 6 AM read, "Felbamate Q6hr (every six hours) . . . . Pt (patient) own meds." Physician orders of 9/21/12 at 11:42 AM read, "Med - nonformulary & Pt own med . . . . Felbatol (1200 MG) 2 tablets BID (twice a day)." Felbatol is an ant-seizure medication.

The History & Physical, dictated on 9/21/12 at 1:22 PM, read, "Present medications . . . . Albuterol sulfate . . . Advair . . . Felbamate . . . Phenytoin . . . . Continue all home medications as dictated above."

The record revealed that Felbatol was administered on 9/21/12 and 9/22/12 as ordered. A nurse's note on 9/22/12 at 12:45 PM read, "Received pt to medical floor". Thus, the patient had left the Clinical Decision Unit at this time.

A nurse's note on 9/23/12 at 10 PM read, "Pt's (patient's) own med, Felbatol, not available to be given." A review of the Medication Administration Record confirmed this statement as it revealed that this medication was not given at any time during 9/23/12. A nurse's note on 9/24/12 at 11:02 AM (the next day) read, "Pts seizure medication found in CDU (Clinical Decision Unit) and brought up to med room, med given to pt as per MD (Medical Doctor) orders." This medication had been ordered on [DATE]. Thus, orders had not been followed as written on 9/23/12.

A review of facility policy "Medication Management Plan" revealed the following: "Medication shall be administered by licensed personnel in accordance with Florida laws and regulations governing such acts. This includes . . . . nurses proper licensed and certified to administer medication in their respective professional area". Since the patient had not received Felbatol on 9/23/12, the nurse did not comply with Federal regulations 482.23(c)(1) which specify that medications be administered to patients per physician order.

During an interview of the Director of Quality at approximately 5 PM she confirmed the preceding.