Improper Labeling and Storage of Inhalation Medication
Penalty
Summary
Surveyors observed that an opened budesonide inhalation solution foil pouch for one resident was not labeled with the date it was opened, and five inhalation solution ampules were stored outside the protective foil pouch in a medication cart. The Licensed Vocational Nurse (LVN) confirmed that the facility's policy requires multi-dose products, such as inhalation solutions, to be labeled with the date they are first opened to determine their expiration. The LVN also stated that, according to the manufacturer's guidelines, inhalation solutions must remain in the foil pouch or, if stored outside, be discarded within two weeks. Since the date of opening was not documented, it was unknown when the five ampules would expire, and they were considered expired and potentially ineffective. The Director of Nursing (DON) confirmed that inhalation solutions removed from their foil pouches must be labeled with the date of removal to determine the beyond use date, and that any solutions stored outside the pouch expire in two weeks. The facility's policy and the manufacturer's instructions both require proper labeling and storage to ensure medication effectiveness. The failure to label and store the budesonide inhalation solutions as required resulted in the presence of potentially expired medication in the medication cart, with no way to determine if it was still safe or effective for use.