Expired Medications and Hand Sanitizer Not Removed from Use
Penalty
Summary
The facility failed to ensure the safe provision of pharmaceutical services by not removing expired hand sanitizer from a resident's bedside and by not discarding an expired inhalation medication from a medication cart. In the first instance, a resident with a history of urinary tract infection, E. coli, and dementia was found to have two hand sanitizers on the bedside table, one of which had expired several years prior. Staff interviews confirmed that hand sanitizers should not be left at the bedside due to the risk of accidental ingestion and that expired sanitizers are ineffective and should be discarded according to facility protocol. The facility's policy also requires the environment to be free of hazards, including expired sanitizing agents. In the second instance, an expired fluticasone and salmeterol inhalation powder Diskus, used for treating COPD, was found in a medication cart. The medication had been opened and marked with the date, but was not removed after the one-month expiration period as required by both manufacturer guidelines and facility policy. Multiple licensed nurses, including the one interviewed, failed to remove the expired medication, resulting in nine doses being administered to a resident after the expiration date. Staff acknowledged that expired inhalers lose potency and are not effective in treating the resident's condition. Facility policies reviewed indicated that expired or discontinued medications must be immediately removed from stock and stored in a designated area for disposal. The policies also specify that medications should be stored and disposed of according to manufacturer recommendations. Despite these policies, the expired hand sanitizer and inhalation medication remained accessible and in use, contrary to both facility procedures and professional standards.