Deficient Medication Storage, Labeling, and Cleanliness Practices
Penalty
Summary
Surveyors identified multiple deficiencies related to medication storage and labeling practices in the facility. In two out of three medication rooms and four out of five medication carts, drugs and biologicals were not stored or labeled according to accepted professional standards. Specifically, an external air-conditioning unit with a dirty filter containing grayish dust and debris was placed on top of a medication refrigerator, raising concerns from the Infection Preventionist, Director of Staff Development, and Director of Nursing about potential contamination of medications stored inside the refrigerator. Facility policy required medication storage areas to be kept clean, which was not followed in this instance. Additionally, two bottles of Drug Buster solution, used for medication disposal, were found soiled and in active use in two different medication carts. Licensed nurses confirmed the bottles were dirty and posed a risk of cross-contamination within the carts. The Director of Staff Development and Director of Nursing both acknowledged that the presence of dirty Drug Buster could lead to unwanted drug-to-drug interactions and make the carts difficult to clean. Furthermore, pill cutters in three different medication carts were observed with white and grayish residue, and staff confirmed these devices should have been cleaned to prevent cross-contamination between medications. The survey also found that several medications and sterile supplies were opened but not labeled with the date opened, including a bottle of Miralax, a box of Bisacodyl suppositories, and a bottle of Clobetasol Propionate Topical Solution. Single-use sterile wound care supplies were also found opened and available for use in a treatment cart, contrary to manufacturer instructions and facility policy. Staff interviews confirmed the importance of labeling opened medications and discarding opened sterile supplies, as failure to do so could result in the use of expired or non-sterile products.