Unattended Unlocked Medication Cart Accessible in Hallway
Penalty
Summary
The deficiency involves failure to ensure that medications were stored securely and accessible only to authorized personnel. During an observation and concurrent interview, surveyors and the Nursing Supervisor (NS) saw medication cart #2 parked in a hallway outside a resident room, unlocked and unattended. The NS immediately went to the cart and locked it, stating that medication carts should always be locked when left unattended and that they needed to be secured so unauthorized people, including residents, could not access the medications. Shortly afterward, a licensed nurse (LN A) exited the nearby resident room and acknowledged responsibility for medication cart #2, admitting that she had left it unlocked and unattended. LN A stated that facility policy required medication carts to be locked when unattended for resident safety, particularly to prevent confused residents from accessing medications. In a separate interview, the Director of Nursing (DON) confirmed that medication carts must always be locked when unattended because only nurses are authorized to access the medications and that leaving a cart unlocked while unattended was a safety issue. Review of the facility’s “Administering Medications” policy indicated that the cart must be visible to the personnel administering medications and all outward sides must be inaccessible to residents or others passing by.
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