Improper Medication Storage in Facility
Penalty
Summary
The facility failed to ensure proper storage of medications and biologicals for five residents, leading to a deficiency in compliance with the 59A-4.112(6), FAC Drug Storage regulation. Observations revealed that prescription and non-prescription medications were improperly stored at the bedside of several residents. For instance, a plastic bag of bottled pills was found on the nightstand of one resident, and a bottle of medication was observed on the side table of another resident. These medications were not secured in a locked refrigerator or medication room, as required by the regulation. Additionally, during a medication observation, two bottles labeled Acetic Irrigation Solution were found on the nightstand of a resident, which should have been stored in the medication cart. Another resident had a bingo card with discontinued medication in the medication cart, which should have been removed and either sent back to the pharmacy or destroyed. These findings indicate a lack of adherence to the facility's policy on medication storage, which mandates that all medications be stored according to the manufacturer's recommendations to ensure proper sanitation, temperature, light, moisture control, segregation, and security. Interviews with staff members, including LPNs and an RN, revealed that rounds were conducted to check the condition of residents and the environment for safety. However, the presence of medications at the bedside suggests that these rounds were not effective in identifying and addressing the improper storage of medications. The facility's failure to comply with the drug storage regulation was further confirmed by a review of the facility's policy and a statement from the Pharmacist Consultant, who emphasized the importance of removing discontinued medications from the cart.
Plan Of Correction
1. What corrective action will be accomplished? The bottled pills inside a plastic bag were removed from Resident #381's bedside and secured. The was removed from Resident #47's bedside and secured. The from Resident #12's bedside was removed and secured. The 2 bottles labeled Acetic Irrigation Solution were removed from Resident #47's bedside. The bingo card labeled tablet of discontinued medication for Resident #65 was returned to the pharmacy. 2. How we identified other residents having the potential to be affected by the deficient practice & corrective action taken: The DON/Designee conducted an audit of occupied resident rooms and medication carts to ensure no medications or biologicals were at bedside and no discontinued medications were in the med carts. 3. Measures/systematic changes put into place: The DON/Designee re-educated the nursing staff on the facility policy for storage of medications and biologicals. Education for storage of biologicals was added to the new hire orientation and annual nursing education. The pharmacy nurse consultant will audit medication carts monthly to ensure no discontinued medications are stored in cart. 4. How corrective action will be monitored: The DON/Designee will conduct daily observation room rounds audit (times 5 weeks) to ensure no medications or biologicals are at bedside. Med cart audit for discontinued medications weekly (times 5 weeks). The results of these audits will be reviewed at the monthly QA meeting until compliance has been determined.