Medication storage was not secured when the keys to a med cart were left in a narcotic count binder and an unlocked treatment cart contained prescription creams and dressings. An LN stated the keys had been left there because two LNs were on the cart, and an Administrative Nurse stated cart keys were expected to stay on the nurse or CMA and carts were to remain locked.
Unattended unlocked treatment cart with resident medications. An LPN left a treatment/med cart unlocked and unattended while entering a resident room, with the cart containing nebulized txs, topical meds, dressing supplies, and multiple insulin pens for several residents. The LPN stated the cart should never have been left unlocked and unattended, and the ADON stated the cart should be locked whenever staff walked away and resident information should not be visible to unauthorized persons.
A facility failed to label one resident’s Humalog FlexPen with an open date and expiration date when first used and failed to discard another resident’s expired Lantus FlexPen. During treatment cart observation, one insulin pen had no date labels and the other had already passed its expiration date, despite the facility policy requiring dates to be recorded and expired meds to be removed.
A facility failed to properly store and label insulin flex pens when an outdated Humalog pen for a resident was left on the med cart and two Novolog pens for two residents were missing open and discard dates. An LPN and an administrative nurse verified that insulin should be dated when opened and expired pens discarded, and the facility policy required medications to be stored safely and outdated meds removed from stock.
Unlocked Medication Cart Left Unattended: A CMA left a med cart unlocked and unattended while stepping into a resident's room, and the same cart was later found unlocked again while the CMA was cleaning up another med cart. An RN and an admin nurse stated med carts should be locked whenever staff walk away from them, and the facility policy required drugs and biologicals to be stored in locked compartments.
Unsecured Medication Cart Observed in Hallway: Surveyors observed a large rolling med cart unattended in a second-floor hallway with the lock partially pushed in. The cart contained stock bottles, resident-specific med cards, and personal drink cups. An LPN stated she thought the cart was locked and confirmed it should always be locked when unattended or out of sight. The facility policy did not address resident med carts.
Outdated insulin was found on a treatment cart when a resident’s Novolog flex pen was observed with an expired discard date. An LPN confirmed outdated insulin flex pens should be discarded, and an Administrative Nurse confirmed staff should check insulin pens for expiration dates and discard expired ones.
Unattended Medication Cart Left Unlocked: Staff left the 100-hall med cart unlocked and unattended across from the nurse's station, with the keys resting on top of the cart and no staff in sight. A CMA, an LN, and an Administrative Nurse all stated the cart was supposed to remain locked when unattended, and facility policy required medications and biologicals to be stored safely and securely.
A resident's Lantus pen was observed without an open date or discard date. An LPN and an administrative nurse stated insulin pens should be labeled with the date opened and a discard date, and the facility policy stated insulin should be dated when opened and is outdated 28 days later.
Surveyors found that insulin pens for two residents on a medication cart were not properly labeled, with one Lantus pen having an unreadable opened date and one Novolog pen lacking any opened or discard date, despite facility expectations that nurses label insulin with the date opened and expiration. In a medication room, a multidose vial of tuberculin solution was also found in use without an open date, even though staff acknowledged it should be dated and discarded within 30 days, contrary to the facility’s Storage of Medication policy requiring complete and accurate labeling of all drug containers.
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