Deficient Medication Storage and Labeling Practices
Penalty
Summary
Surveyors observed multiple failures in the storage and labeling of drugs and biologicals. On the west medication cart, two loose white pills and two loose pink pills were found in the top drawer, and an insulin vial for a resident did not have an open date. The LVN present was unable to identify the loose pills and confirmed that such pills should be discarded, not administered. The DON confirmed that loose pills should not be present in medication carts and that both insulin vials and their boxes should be labeled with the open date to prevent confusion if separated. In the west hall medication storage room, the refrigerator used for resident medications contained a plastic narcotic lock box that was not permanently affixed, as the padlock was not fully closed and the screws securing the bracket were loose and easily removed. The box contained vials of liquid lorazepam, a controlled substance. The DON demonstrated that the lock was not fully engaged and acknowledged the box was not securely attached. Additionally, the nurse treatment cart was found to have its keys stored in an unlocked container attached to the cart, which an LVN accessed openly. The DON stated that it was acceptable for the keys to be stored in this manner, as they were not in the line of sight and residents were not aware of their location.