Observations
Based on review of the patient records and a discussion with administrative staff, the facility failed to obtain a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, in five of five patient records. A documented drug screen urinalysis includes receiving the results from the CLIA and Department of Health approved laboratory.
The findings include:
Five patient records were reviewed on June 6 and 7, 2011. Five patient records were required to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent. A documented drug screen urinalysis includes receiving the results from the CLIA and Department of Health approved laboratory. The facility failed to obtain a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent in five of five records.
Record #1 - Patient was admitted on June 4, 2011. The urinalysis results were not available during the record review on June 6, 2011. The initial dose of Suboxone was given on June 6 at 10:05 am. The facility failed to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, for this patient.
Record #2 - Patient was admitted on May 31, 2011. The urine screen results were not reported until June 4, 2011. The initial dose of Suboxone was given on June 2, 2011 at 8:14 am. The facility failed to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, for this patient.
Record #3 - Patient was admitted on November 23, 2010. The urine screen results were not reported until November 26, 2010. The initial dose of Suboxone was given on November 24, 2010 at 6:10 pm.. The facility failed to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, for this patient.
Record #4- Patient was admitted on November 16, 2010. The urine screen results were not reported until November 22, 2010. The initial dose of Suboxone was given to the patient on November 16, 2010 at 7:46 pm. The facility failed to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, for this patient.
Record #5- Patient was admitted on September 27, 2010. The urine screen results were not reported until October 5, 2010. The initial dose of Suboxone was given to the patient on September 29, 2010 at 6:21 am. The facility failed to document a drug screen urinalysis prior to the administration of Suboxone, a narcotic agent, for this patient.
This was discussed with administrative staff at the exit summary and was confirmed that the facility utilizes the Rapid 8 drug test for the initial drug screen urinalysis. The facility does not have a waiver to use the Rapid 8 test.
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Plan of Correction
Marworth will comply with the licensing standard to obtain a documented drug screen urinalysis prior to the administration of Suboxone. Marworth medical director has begun work with the facility's contracted lab, Quest, to provide a faster "turnaround" in the lab results.Various turnaround options will be explored, including more frequent courier transports of specimens. Full compliance should occur no later than August 30, 2011. If Lab cannot/will not assist wth compliance, a new lab will be sought. |