Unsecured Medications Left Unattended on Medication Cart
Penalty
Summary
A plastic bag containing medications was observed left unattended on top of the south medication cart on the fourth floor, where 24 residents resided. The bag included loose pills and pills in containers. The medication cart was unattended at the time of observation. A Registered Nurse (RN) at the nursing station confirmed that the bag contained medications, which she had found in a resident's room. The RN stated she removed the medications from the room with the intention of notifying the supervisor but was called away to assist with an emergency, leaving the medications unsecured on the cart. Further interview with the RN revealed that any medications found in residents' rooms should be given to the supervisor and not left on the cart. The Director of Nursing (DON) confirmed that medications are to be kept in a locked cart and, if found in a resident's room, should be secured and labeled until picked up by family. Facility policy requires all drugs and biologicals to be stored in a safe, secure, and orderly manner, with nursing staff responsible for maintaining medication storage areas. The observed practice did not comply with these requirements.