Expired Vaccines and Inadequate Temperature Monitoring in Medication Storage
Penalty
Summary
The facility failed to ensure that expired vaccines were discarded and did not follow CDC guidance for monitoring the temperature of vaccines stored in the medication storage refrigerator in the East/West Medication Storage room. During an observation, it was found that the refrigerator contained 24 influenza vaccines that had expired, along with other medications such as Apisol, Alteplase, and insulin pens. The refrigerator thermometer showed a questionable reading of 66 degrees Fahrenheit, and staff were unsure if this was accurate. The Infection Prevention Nurse indicated that night shift nurses were responsible for reading and recording refrigerator temperatures, but the logs revealed multiple missed temperature documentation entries over several months. The Director of Nursing was unaware of the expired vaccines and stated that the unit manager was supposed to monitor for outdates and ensure accurate temperature documentation. The Regional Nurse Consultant confirmed that temperature checks for refrigerators containing vaccines were to be completed twice daily. Despite these expectations, the temperature logs showed numerous days with missing documentation, indicating a lack of consistent monitoring. The failures to discard expired vaccines and to properly monitor and record refrigerator temperatures were in direct violation of facility policy and CDC guidance.