Unlocked Wound Care Cart with Unsecured Keys Left Unattended
Penalty
Summary
A wound care cart was observed parked in the hallway in front of the nurses' station, left unlocked with keys placed on top of the cart. The drawers of the cart, which contained various wound care supplies including ointments, creams, wound cleansers, and other medical items, were easily accessible to anyone passing by, including residents, staff, and visitors. Multiple staff and residents were seen passing in front of the cart, and the drawers could be opened without restriction. The cart was not under the direct observation of authorized staff at the time of the observation. Interviews with the ADON, DON, and the Administrator confirmed that facility policy requires all carts containing drugs and biologicals to be locked when unattended and that keys should not be left unsecured. The DON identified that the night nurse had left the cart unlocked and the keys on top of it. LVN A admitted to forgetting to lock the cart and secure the keys after providing wound care earlier that morning, citing being busy as a factor but acknowledging that this was not an acceptable excuse.