HospitalInspections.org

Based on observation, interview and record review, two (#10 and #11) of two patients receiving medications via inhalation did not receive medications at times ordered by the physician. Findings include:

On 6/2/10 from 1300-1600 review of patient #10 's medical record revealed documentation that breathing treatments were not always administered in accordance with physician orders. Upon admission, MD #2 ordered Albuterol inhalation treatments to be administered every 6 hours. On 4/16/10 this treatment was documented as given at 2217. It was next documented 4/17/10 at 0604. On 4/17/10 a dose was documented at 1100. The next documented dose was at 2250. On 4/18/10, there was no documentation of a treatment given between 0750 and 2230. These findings were confirmed by the CCO (Chief Clinical Officer).

On 6/3/10 at 1030 patient #11 stated that his medications and respiratory treatment were late. RN #2 apologized to patient #11 and stated she would check with Respiratory. On 6/3/10 at 1040, review of patient #11's clinical record revealed that physician orders for Albuterol Sulfate (2.5 mg/3ml) 0.083% and Ipratropium Bromide 0.02% solution via nebulizer every 4 hours and Fluticasone Propionate HFA inhalation to be given every 12 hours. Missed doses of Albuterol Sulfate (2.5 mg/3ml) 0.083% and Ipratropium Bromide 0.02% solution were documented on the "Administered Medications" record on: 5/17/10 at 2100, 5/19/10 at 0900, 5/24/10 at 1700, 5/26/10 at 0500, 5/27/10 at 2100 and 5/29/10 at 0100. Missed doses of Fluticasone Prionate HFA were documented on 5/20/10 at 2100 and 5/25/10 at 2100. These findings were verified by the CCO.

Facility policy PHR mm 50.01, Administration of Medications", approved 12/4/08, states:
1.T. "Mediations will be administered within 60 minutes of the scheduled time."