Nurses Caught Administering Insulin To Non-Diabetic Nursing Home Residents

New York Nursing Home inspectors were recently called to investigate, Hilltop Nursing Home, following two incidents where nurses at the facility gave insulin to non-diabetic residents.  The residents went into shock and were hospitalized.  According to a report from the  New York Department of Public Health, the two incidents were investigated following tips made on the telephone hot line.  One of the insulin errors involved an LPN who admitted to being under the influence of narcotic medications not prescribed to her. 

During the recent health department investigations, investigators also determined that nurses at the facility signed on narcotic medications for resident use, but there was no documentation that the medications were actually administered.  Upon discovering this situation, the findings were turned over to the Bureau of Narcotics Enforcement.

Hilltop Nursing Home is a short-term sub-acute facility certified for 110 residents and has a staff of 200.  It specializes in treatment of traumatic brain injury and pediatric care. Hilltop Nursing Home has been part of the government's nursing home watch list or "Special Focus Facility" since 2006 when an 11-month-old boy stopped breathing for 20 minutes following the displacement of his breathing tube.  The boy suffered brain damage from the incident.  An inspection of the incident confirmed the boy received improper medical care and the staff failed to timely respond to alarms signaling a problem.

The 'special focus facility' designation cases nursing home inspectors to visit the facility more frequently.  Nursing homes remain part of the 'special focus facility' watch list until they pass two consecutive surveys without major violations.  Well, after these incidents involving medication errors, Hilltop will remain on nursing home inspectors short list.

Read more about this medication error at a New York Nursing Home here.

Pile On The Medication

Old?  Weak? Tired? Have dementia?  The answer to these ailments in some nursing homes is to prescribe antipsychotic drugs to subdue any signs of energy and life left in residents suffering from Alzheimer's and other forms of dementia.  A whopping one-third of all nursing home residents are prescribed antipsychotic drugs such as: Risperdal, Seroquel and Zyprexa.

Prescription of antipsychotic drugs is big business for their makers.  Sales of Risperdal, Seroquel and Zyprexa have more than tripled from 2000 to 2007.  Dispensation of the drugs is also often profitable for the facilities where the patients reside.  Every time medication is given, it is an opportunity for a nursing home to charge.  Most often the charges are tacked onto the Medicare and Medicaid tab.

Use of antipsychotic drugs continues despite recent studies that have demonstrated their ineffectiveness in Alzheimer's patients with aggressiveness and delusions.  The wide spread use of antipsychotic drugs covers up the fact that most facilities are understaffed.  It is far easier to have a patient down a couple of pills than to provide skilled nurses, psychiatrists and therapists to treat their underlying needs.

Read the full New York Times article on overuse of medication in dementia here.