Safely storing meds is problem for many
Providers continue to struggle with The Joint Commission standard to safely and properly store medications (MM.03.01.01), with 22% of ambulatory organizations and 34% of hospitals being noncompliant in the first half of 2008.
Additionally, medication errors are the fourth most common type of sentinel event, with 46 reported in 2008 and 11 already reported in 2009.
The standard "can be challenging because often lots of people forget, because the same-day surgery patient is, in general, healthy," says Sophie Duco, RN, associate director of standards interpretation, hospital accreditation, at The Joint Commission. For example, a hospital-affiliated surgery program might be off-site and not have experienced the same type of pharmacy involvement with medications that on-site programs have, she says. "Pharmacy will procure meds, provide policies and procedures, but may not visit those off-site facilities or may not visit them with any frequency," Duco explains. Such situations leave the outpatient surgery managers responsible for ensuring medications are stored appropriately in their area.
Ginny McCollum, MSN, RN, an associate director of standards interpretation at The Joint Commission, says that in terms of refrigerated medications, "you should have a mechanism to be able to monitor, not only daily when you're there, but when the organization is closed."
There are electronic digital monitoring devices for the medication refrigerator and tissue refrigerator so you know the temperature at all time, she says. "When you come in on Monday, you know was there a blackout, and there was 24 hours of lost temperature," McCollum says.
Inexpensive recording thermometers will indicate when a refrigerator temperature is out of range, Duco notes. "The key is that the staff must act upon that finding," she says.
Ensure that expired medications, including multidose vials, are removed, she says. "Managers forget to go back and round to make sure no expired meds are available," Duco says. "Lack of daily pharmacy involvement can be lost on staff already busy on patient care paperwork."
What happens to meds throughout the day?
Ensure that the organization has a policy to safely manage medication that might be gathered up by a particular provider at the beginning of his or her shift, Duco says.
For example, in outpatient surgery, an anesthesia provider might gather up medications for all of the day's cases. "The organization has to have a policy in place that addresses safe storage, safe handling, security, and disposition of meds at the end of that person's shift," she points out.
The question arises, then, how will anesthesia providers manager their meds through they day? "If they have a lunch break, what do they do with those meds they gathered up?" Duco asks. It is critical not only that a policy be developed, but that the manager ensure the policy is implemented.
Also, with controlled substances, there are federal rules and regulations, as well as the facility policy to comply with, Duco says. "Many organizations have gone to [a policy that] you pull meds for one case at a time," she says. One added advantage of such a system is more accurate billing and disposition, Duco adds.
Also don't forget the crash carts, says Michon Villanueva, assistant director of accreditation services at for the Accreditation Association for Ambulatory Health Care. "Organizations periodically forget to check their crash card for expired medications," she says.
Providers continue to struggle with The Joint Commission standard to safely and properly store medications (MM.03.01.01), with 22% of ambulatory organizations and 34% of hospitals being noncompliant in the first half of 2008.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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