Failure to Properly Label Opened Insulin Pens and Ophthalmic Drops
Penalty
Summary
The deficiency involves the facility’s failure to ensure medications were labeled in accordance with professional standards and the facility’s own Medication Labeling and Storage policy, which states that nursing staff are responsible for maintaining medication storage in a safe manner and ensuring medications are labeled accordingly. Manufacturer guidelines for Tresiba (insulin degludec) FlexTouch pens require opened pens stored at room temperature to be discarded after 56 days, NovoLog (insulin aspart) pens after 28 days, and Xalatan (latanoprost) ophthalmic solution after 6 weeks at room temperature. Residents involved included one with Type 2 diabetes, chronic pain syndrome, and hypertension; another with Type 2 diabetes, COPD, and hypertension; and a third with unspecified glaucoma, major depressive disorder, and hypertension, each with active physician orders for these medications. During an observation of a medication cart, surveyors found an opened Tresiba FlexTouch insulin pen for one resident stored at room temperature without an open date, bearing only a label instructing discard after 56 days. They also observed an opened NovoLog insulin pen for another resident at room temperature without an open date, labeled only to discard after 28 days. Additionally, an opened 2.5 mL bottle of latanoprost ophthalmic solution for a third resident was found undated, with a label to discard after 42 days. Both an LPN and the DON confirmed that these medications were not stored properly for the three residents, specifically acknowledging the lack of appropriate labeling with open dates as required.
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