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A nursing home in Palos Heights was fined after a resident was given medications which were ordered for another resident. The resident, who has a documented history of confusion, answered “yes” when the nurse asked him if he the resident for whom the medications were ordered. After this, she continued to give him the other resident’s medications for the rest of the shift and did not discover her error until after the resident was found unresponsive.

The resident was taken to the hospital suffering from hypotension (abnormally low blood pressure) and renal failure.

One of the fundamental principles in adminstering medications is to properly identify the person to whom the medication is being given. As the nurse in this instance was obviously unfamiliar with the residents to whom she was passing medications, additional steps had to be taken to ensure proper identification. It is not acceptable in a nursing hoem environment for the nurse to rely upon residents suffering from confusion.

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