Improper Storage of Barrier Cream and Expired Wound Care Supplies
Penalty
Summary
The facility failed to ensure proper storage and handling of medications and biologicals in two separate instances. For one resident with a history of multi-system degeneration of the autonomic nervous system, neuromuscular dysfunction of the bladder, and muscle weakness, a medication cup containing barrier cream and opened packets of zinc oxide barrier cream were found left open and unsanitarily on the bedside table. The resident had physician orders for daily wound care involving the application of barrier cream to areas of moisture-associated skin damage. Interviews with nursing staff and the infection preventionist confirmed that leaving medication cups with barrier cream at the bedside was not acceptable and not in accordance with facility policy, which requires medication storage and preparation areas to be maintained in a clean, safe, and sanitary manner. In a separate incident, five expired packets of hydrogel saturated gauze were found in the treatment cart in front of the nurse's station. The gauze had expired over a month prior to the observation. Facility policy requires that all expired medications be removed from active supply and destroyed. Interviews with nursing staff and the DON confirmed that the expired items should have been removed and that the policy was not followed. A nurse acknowledged responsibility for checking the treatment cart weekly to ensure all items were within expiration dates.