Failure to Secure Treatment Carts and Properly Label Medication
Penalty
Summary
Surveyors observed that two treatment carts in separate units were left unlocked, one in the back nurses' station of the Hallbrook unit and another in the hallway of the Bridgewood unit. Both carts contained medical ointments and wound cleansers. Additionally, in the medication storage room on the Hallbrook unit, a refrigerator inspection revealed two vials of tuberculin serum, one of which was opened without any dates indicating when it was opened or when it should expire, and the other had been opened and was past its 30-day expiration date. Interviews with nursing staff confirmed that carts were expected to be locked when not in use and that staff were responsible for securing carts and patient information when stepping away. The facility's policy required all medications and biologicals to remain locked and secured to prevent tampering or exposure.