Improper Medication Labeling and Storage on Multiple Medication Carts
Penalty
Summary
Surveyors identified a deficiency in the facility’s medication labeling and storage practices on three of three medication carts reviewed, affecting seven residents. During observations on multiple medication carts, several open medication containers lacked required open dates, including liquid potassium chloride 10% for a resident with dementia with psychotic disturbance, guaifenesin liquid for multiple residents with conditions such as aphasia following cerebral infarction and unspecified dementia, Biotene Dry Mouth oral rinse for a resident with paroxysmal atrial fibrillation, chlorhexidine 0.12% mouthwash for a resident with chronic obstructive pulmonary disease, and lactulose for a resident who had already been discharged. Additionally, an open vial of lidocaine 1% was found on a cart without an open date and without a current physician order for the resident with malignant neoplasm of the right kidney. Record review showed that several of these medications had been discontinued by the physician on or before the survey dates, yet the open containers remained on the carts without proper labeling or removal. The DON stated that the lidocaine should have been removed from the cart when it was no longer needed for a resident’s antibiotic treatment and acknowledged that the nurse who opened the medications should have dated them. The facility’s own Medication Storage policy required medications to be stored and monitored for expiration dates consistent with applicable laws and regulations, including 410 IAC 16.2-3.1-25(j), but the observed practices did not comply with these requirements.
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