Deficient Medication Storage and Labeling Practices
Penalty
Summary
Surveyors identified multiple deficiencies in the facility's medication storage practices, including improper labeling, unsanitary conditions, and failure to maintain required temperature ranges for drugs and biologicals. Observations revealed that unopened insulin was stored below the recommended temperature range of 36°F to 46°F in one of two medication refrigerators, with temperature logs showing readings as low as 30°F. Staff members, including LPNs, RNs, and the DON, were unable to state the correct temperature range for refrigerated medications, and the temperature log did not reference the correct parameters or actions to take when temperatures were out of range. Additionally, the main medication refrigerator contained expired medications and medications for discharged residents, and some medications were stored in wet or unsanitary conditions. Further inspection of medication carts revealed unsanitary conditions, with drawers containing trash, spilled liquids, and medications not separated from equipment such as glucometers and blood pressure cuffs. Medications were not consistently labeled or dated, and some insulin pens in use were not stored in a sanitary manner, being placed together in a single section of the drawer without individual bags. Expired medications were found in the carts, and ophthalmic and otic medications were not stored separately as required by facility policy. Staff interviews confirmed a lack of knowledge regarding proper storage, labeling, and separation of medications, as well as the need to discard expired medications. The facility's policy required medications to be stored according to manufacturer recommendations, with regular monitoring of storage conditions and immediate removal of outdated or deteriorated medications. However, observations and staff interviews indicated that these policies were not consistently followed. The consultant pharmacist confirmed the accepted temperature range for refrigerated medications and the need to follow manufacturer guidelines, but also noted uncertainty about some storage practices. The deficiencies were identified through direct observation, record review, and staff interviews, highlighting failures in maintaining safe and effective medication storage.