Failure to Label Insulin Products Properly
Penalty
Summary
The facility failed to ensure that insulin pens and vials were labeled in accordance with currently accepted professional principles. During an observation of the fourth floor north medication cart, it was found that several insulin products were opened and undated. Specifically, a Lantus insulin pen for one resident, a Lantus insulin vial for another, a Lispro insulin vial for a third resident, and an Admelog insulin vial for a fourth resident were all found to be opened without any recorded date of opening. The facility's policy, "Medication Administration/Disposition," which was reviewed in December 2024, requires that the date of opening be recorded on multi-dose containers. However, this policy was not adhered to, as evidenced by the undated insulin products. Employee E8, a licensed nurse, confirmed these findings during the observation. This deficiency indicates a failure to comply with both state and federal regulations regarding the labeling and storage of drugs and biologicals.
Plan Of Correction
This plan of correction is submitted to comply with federal regulations. This plan is not an admission of guilt, or wrongdoing, nor does it reflect agreement with the facts and conclusions stated in the statement of deficiencies. R17 insulin pen was removed and replaced. R132 insulin vial was removed and replaced. R95 insulin vial was removed and replaced. R83 insulin vial was removed and replaced. The DON/designee audited the remaining medication carts to ensure insulins were labeled and dated. Licensed staff were educated on the medication administration/disposition policy which includes dating a multi-dose container with the date it was opened. The DON/designee will audit medication carts to ensure insulins are labeled and dated per policy. Audits will be done weekly x 4 weeks then monthly x 2 months. Results of these audits will be submitted to the quality assurance committee to determine if further action is needed.