The IDPH has cited Accolade Healthcare Paxton Senior Living in Paxton, IL, for a medication error affecting a resident with a knee infection. The infection began after the resident had a knee replacement surgery, and it persisted after the nursing home failed to provide her antibiotics.
Missed Antibiotics Crucial to Treat Infection
The female resident was originally admitted to the senior care facility because her knee prosthesis surgery led to a knee infection. At the time of her admittance, her prosthesis had been removed and replaced with a spacer, a device designed to fill the joint gap. She was meant to get antibiotics to clear up her infection, and only then would she get a new prosthesis.
Soon after her nursing home admission, there was concern that her infection was migrating to the soft tissue next to her knee joint. If the infection was allowed to move, she could lose her leg. Hence, she was sent back to the hospital.
Doctors allowed her to return to the nursing home with an order for two antibiotics called Fortaz and Vancomycin. However, neither was on hand at the nursing home when she arrived. A nurse practitioner found out four days later that the resident missed three doses of Fortaz and one dose of Vancomycin.
The resident developed a fever, which prompted another hospitalization. She had to undergo surgical removal of the spacer. On the operative note, the indication for surgery was the missed antibiotics.
Multiple Lapses in Resident’s Care
We see at least three shortcomings at the nursing home that led to this resident’s prolonged suffering.
One is the lack of continuity of care. Individuals who are admitted into a nursing home after a hospital stay should have the continued treatment they need to get well. Before the resident’s transfer, the hospital must send to the nursing home the treatment orders and medication list, and the nursing home must implement them as soon as the resident arrives.
This standard protocol for continued care was not followed through for the resident at issue. As a result, she missed her crucial medication and ended up having to get another surgery.
Another problem was the facility’s admittance of the resident without complete preparation. Nursing homes are supposed to be ready to implement a resident’s care plan to the letter, the moment the resident is admitted. In terms of medical treatment, a well-run facility will have a backup supply of medications or even an on-call pharmacy to supply what is needed.
Unfortunately, in this case, the nursing home did not take proper steps to prepare for the resident’s admittance. The lack of onhand medicine should have been addressed with a resupply.
The third issue was that the nursing home staff failed to check on the patient’s care and notify the physician. Senior care facilities are not required to have a doctor present 24/7, but they are required to let a doctor know when there’s a medical issue with any resident. Nurses and staff at the facility are supposed to be the doctor’s “eyes and ears” to spot these issues.
Sadly for this particular resident, no one at the nursing home checked if she was getting the ordered medicine. Thus, the doctor could not immediately advise on how to address it. Four days passed before a nursing practitioner noticed, and by that time, there was no choice but to send the resident back to the hospital.
No nursing home resident should have to suffer due to any of these lapses, much less a combination of several.
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