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Based on observation, interview, and document review, 1 of 3 outpatient clinics observed failed to ensure drugs were stored in secure areas to prevent unauthorized persons from obtaining access.

Findings include:

A tour of the Alexandria Clinic was conducted on 9/4/14, at 12:15 p.m. with director of clinical services (DCS)-A, patient flow coordinator (PFC)-B, and clinic supervisor (CS)-C. The urgent care department had a locked cupboard located in the back of the clinic, which the CS-C identified as the facility narcotic cupboard. The CS-C obtained the key which was located in an unlocked drawer next to the cupboard. The cupboard contained a small, unlocked Rubbermaid container with drawers, which contained the following:
One, 2 ml (milliliter) vial of Versed.
18, 2 ml vials of Fentanyl.
22, one ml vials of Morphine.
27, one ml vials of Tordal.

The urgent care also had a locked medication refrigerator, and the key was hanging on the side of the fridge. The fridge contained two, 1 ml vials of Ativan.

CS-C stated the narcotics were counted daily by the nurses, however, the keys were always kept next to the cupboard and fridge, and the narcotics did not contain a double lock system for security, nor was the Rubbermaid container secured.

In patient room 239 in urgent care, a cupboard which was not able to be locked, contained the following medications:
3 Epinephrine pens.
One, 30 ml vial of Epinephrine.
Two, 20 ml vial of epinephrine with Lidocaine.

CS-C stated the cupboard in patient room 239 did not contain a locking system and was not able to be locked.

During tour of the urology department, the procedure room had a cupboard which was not able to be locked and contained the following medications:
20, one ml vials of heparin.
2, 125 mg vials of Solumedrol.

CS-C stated the cupboard in the patient procedure room did not contain a locking system and was not able to be locked.

(DCS)-A stated all cupboards containing medications should be locked to prevent unauthorized access to medications. DCS-A stated the clinic was in the process of installing a new locking system for medications which required a badge to obtain access. DCS-A stated in the evening after the clinic closes at 7:00 p.m., there is maintenance and housekeeping that enters the building and has access to all clinic areas.

During interview on 9/4/14, at 1:10 p.m., pharmacist (P)-A stated the pharmacy department does audits of the outpatient clinics to ensure medications are secured and locked. P-A stated the narcotic storage was not considered secure, and the nurses should be carrying the keys with them, and not leaving them in a drawer next to the cupboard/ fridge. P-A stated he was not aware of the unlocked medications stored in the patient rooms and all medications in patient areas should be locked.

A specific policy was requested regarding securing medications in patient areas in the outpatient setting, however, the facility was unable to provide a specific policy related to outpatient medication security.