Failure to Reconcile and Dispose of Discontinued Medications
Penalty
Summary
The facility failed to dispose of or reconcile discontinued medications in a timely manner in the West Medication Room. During a review, a grey plastic basin containing various medications was found unsecured and unaccounted for on the counter. The medications included Neurontin, Levemir, Lantus, Amlodipine, Ibuprofen, Coumadin, Eliquis, Tylenol, Motrin, Zyrtec, Senna, Lipitor, Remeron, Metoprolol, Prednisone, Mucinex, Ezetimibe, Keflex, Nitroglycerin, Lopressor, Cymbalta, Simethicone, Rochepin, Miralax, Milk of Magnesia, Ertapenem, Lispro, Humalog, Voltaren Gel, and Delsym. These medications were not properly secured or documented, contrary to the facility's policies on medication storage and disposal. The Director of Nursing (DON) confirmed that the facility did not have a system in place for the accountability or disposition of discontinued medications. The DON stated that medications are discontinued in the computer system, removed from carts, and placed in a bin for pharmacy pickup, which occurs approximately once a week. However, there were no accountability or disposition forms filled out for these medications, indicating a lack of proper reconciliation and documentation as required by the facility's policies and federal regulations.
Plan Of Correction
Medications were picked up for disposal by the pharmacy at the time of survey. All medication rooms were audited for medications awaiting pickup disposal at the time of survey. The facility has implemented a carbon copy pharmacy form system for medication reconciliation/disposal as well as a pharmacy request form if medication volume requires more frequent pick up for disposal. The DON or designee will educate all licensed nursing staff on the new forms, reconciliation and disposal process. The DON or designee will audit the medication rooms for proper use of the new reconciliation/disposal system daily for 3 days and then weekly x 8 weeks. All results to be reviewed through QAPI for further recommendation.