Failure to Properly Dispose of Medications and Replace Emergency Kit
Penalty
Summary
The facility failed to follow its own policies and procedures regarding the destruction of prescription medications and the timely replacement of the narcotic emergency kit (e-kit) after use. During an observation, a licensed nurse was found to have placed amiodarone and another unidentified loose pill inside a used latex glove and stored it in the medication cart, rather than disposing of the medications immediately in a drug buster as required. The nurse confirmed that there was no drug buster available on her cart at the time. The Director of Nursing also confirmed that all medication carts were supposed to be equipped with a drug buster and that staff were expected to use it for medication disposal, not a glove. Review of the facility's policy indicated that all non-controlled drugs eligible for disposal should be placed in an approved waste container. Additionally, an inspection of a medication storage room revealed an e-kit with a broken seal, indicating it had been opened, but it had not been reordered from the pharmacy as required. The log inside the e-kit showed that medication had been removed, and the registered nurse confirmed that the e-kit should have been reordered as soon as it was opened. The facility's policy stated that opened e-kits must be replaced with sealed kits within 72 hours and that the nurse who uses the medication is responsible for notifying the pharmacy for replacement. The Director of Nursing confirmed that the expectation was for opened e-kits to be replaced promptly according to policy.