Expired Supplies and Inadequate Monitoring of Crash Cart Medications
Penalty
Summary
Surveyors identified a deficiency in the storage and monitoring of drugs and biologicals on the crash cart located at the central nurse's station. During an observation, the crash cart contained 86 individual alcohol wipes with an expiration date of 10/3/2024 in the third drawer, indicating expired medical supplies were available for resident use. The facility’s Medication Access and Storage policy, dated 5/2007, required that outdated, contaminated, or deteriorated medications be immediately removed from stock and disposed of according to procedures for medication destruction. Interviews with staff revealed that night shift nurses were responsible for checking the crash cart each shift to ensure all medications and supplies were current and accounted for, and that an ADON occasionally checked the cart after night nurses to ensure it was done properly. The administrator stated that ADONs and a pharmacy technician completed cart audits, and that nurses were expected to maintain the cart and complete a daily checklist, with nursing leadership monitoring the process. An attempted interview with the night nurse who had signed off on checking the crash cart on the day of the observation was unsuccessful, leaving unresolved how the expired alcohol wipes remained on the cart despite documented checks.
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