Failure to Label Insulin Pens and Monitor Medication Refrigerator Temperatures
Penalty
Summary
Surveyors observed that the facility failed to ensure proper labeling and disposal of insulin pens and did not consistently monitor medication refrigerator temperatures as required. During inspection of a medication cart, an open Novolog insulin pen was found without the required open and expiration dates labeled, despite a sticker being present for this purpose. Another insulin pen was found with an expired date, yet it remained in use. Staff interviews confirmed that insulin pens should be dated when opened, have an expiration date of 28 days, and be disposed of when expired, but these procedures were not followed for the insulin pens belonging to the residents reviewed. Additionally, the medication refrigerator used to store insulins and other liquid medications was found to have incomplete temperature monitoring logs. The log indicated that temperatures were only checked once daily instead of the required twice daily, and there were missing entries for several days. Multiple insulin pens for different residents were stored in this refrigerator. The facility's policy requires that insulin pens be dated when opened, include an expiration date and staff initials, and be discarded when expired, as well as that refrigerator temperatures be checked and documented twice daily, but these protocols were not adhered to.