Failure to Date Opened Insulin Vials and Pens
Penalty
Summary
Surveyors observed that the facility failed to label insulin vials and pens with the date they were opened, as required by professional standards and facility policy. During inspection of medication carts on two separate hallways, multiple insulin vials and pens for several residents were found without open dates. Nursing staff interviewed were unaware of why the insulins were not dated and acknowledged that it was their responsibility to ensure insulins were dated upon opening, as these medications are only effective for 28 days after being opened. Both LVN and RN staff admitted to administering insulin from undated vials and pens, not realizing the absence of open dates. The Director of Nursing confirmed awareness of the issue and stated that it was the responsibility of the charge nurse to check for open dates before administration. The facility's policy, revised in February 2023, requires that multi-dose vials be dated when opened and discarded within 28 days unless otherwise specified by the manufacturer. The failure to date opened insulin vials and pens was identified through observation, interview, and record review, and was found to be inconsistent with both facility policy and accepted pharmaceutical practices.