Unsecured and Unlabeled Medications at Bedside
Penalty
Summary
Surveyors observed that a resident had a tube of Ease-Z Diabetics dry skin therapy foot cream containing zinc and a bottle of ActivICE pain reliever gel roll-on left unsecured on her bedside table. Staff interviews confirmed that these items were brought in by the resident's family and were not secured or labeled with a pharmacy label, nor was there a physician's order for their use. The LPN on duty was unaware of the contents or necessity of these creams, and the DON acknowledged that all medications, including creams, should be secured and have appropriate orders. Further review of facility policy indicated that non-prescription medications not labeled by a pharmacy should be kept in the manufacturer's original container and identified with the resident's name. The DON and Regional Nurse Consultant verified the presence of the unsecured creams during their observation. The facility's failure to secure these medications and ensure proper labeling and orders led to the deficiency cited by surveyors.