HospitalInspections.org

Based on policy review, observation and interview, it was determined the facility failed to ensure unusable drugs and biologicals were not available for patient use in 4 of 7 (Emergency Department [ED] storage shelf, cabinet in ED Room #1, medication closet in ED, and medication cart on the floor) medication storage areas.

The findings included:

1. Review of the facility's "EXPIRED MEDICATION DISPOSITION" policy revealed, "At the beginning of each month, medications which expired the previous month are pulled off the pharmacy shelves and from floor stock around the hospital..."

2. Review of the facility's "AUTHORIZED AREA FOR OUTDATED AND UNUSUABLE DRUGS" policy revealed, "All outdated medications will be pulled from stock and placed in a cleearly-marked, authorized area for outdated drugs..."

3. Review of the facility's "MULTI-DOSE VIALS" policy revealed, "...All multi-dose vials when first used or open are to be dated. After a thirty (30) days dating these have to be returned to the pharmacy. This is a hospital regulation..."

4. Observations at the storage shelf in the ED on 11/3/14 at 9:40 AM revealed two 500 mililiter (ml) bags of Lidocaine 2 gram (gm) for intravenous usage with an expiration date of June 2014.
During an interview at the time of the finding, the ED director verified the expiration date.

5. Observations at the storage shelf in the ED on 11/3/14 at 9:45 AM revealed one 500 ml bag of Dopamine 400 milligram (mg) for intravenous usage with an expiration date of June 2014.
During an interview at the time of the finding, the ED director verified the expiration date.

6. Observations at a cabinet in Room #1 in the ED on 11/3/14 at 9:54 AM revealed 6 bottles of iodoform packing strip. Two bottles of the packing strip had no expiration date. One bottle of the packing strip had an expiration of 8/2012. One bottle of the packing strip had an expiration date of 12/2012. One bottle of the packing strip had an expiration date of 8/2014.
During an interview at the time of the finding, the ED director verified the findings.

7. Observations at the medication closet in the ED on 11/3/14 at 10:06 AM revealed 2 vials of opened Humulin R insulin without documentation of the date it was opened.
During an interview at the time of the finding, the ED director verified the finding.

8. Observations at the medication cart on 11/3/14 at 11:05 AM revealed 5 vials of Morphine Sulfate 30 ml with an expiration date of 11/1/14.
During an interview at the time of the finding, the Licensed Practical Nurse (LPN) verified the expiration date.

22592

Based on facility policy review, facility record review, observation and interview, it was determined the facility failed to ensure medical equipment and supplies were maintained to ensure an acceptable level of safety and quality for 3 of 5 (Physical Therapy, Respiratory Therapy and Emergency Department) patient care areas observed.

The findings included:

1. Review of the facility policy, "PREVENTATIVE MAINTENANCE PROGRAM" revealed, PURPOSE: To assure proper maintenance of equipment..."

2. Review of the facility contracts for Biomedical Maintenance for 2013 revealed, "[name of company] provides Perry Community Hospital the following biomedical maintenance services described below...Annual Electrical Safety checks on all units, Annual Preventative Maintenance on all units..."

3. Observations in the Physical Therapy (PT) Department on 11/3/14 at 10:30 AM, revealed a Hydrocollator with a yellow biomedical sticker dated 4/2012 with a documented next inspection due date of 4/2013.

Observations in the Respiratory Therapy (RT) Department on 11/3/14 at 10:40 AM, revealed Cardiac Monitor unit's #7 and #8 with a yellow biomedical sticker dated 4/2012 with a documented next inspection due date of 4/2013.

The Medical Records Director was present on the tour of the PT and RT Departments and observed the out of date biomedical stickers

4. Observations in the Emergency Department (ED) on 11/5/14 at 8:20 AM revealed one sized 3 laryngeal tube with an expiration date of 2/2014.

Observations in the ED on 11/5/14 at 8:20 AM revealed one sized 4 laryngeal tube with an expiration date of 9/2014.

During an interview in the ED on 11/5/14 at 8:25 AM, when the Registered Nurse (RN) was asked if the dates were expiration dates, she stated "That's [That is] what it looks like to me."

22592

Based on facility policy review, facility record review, observation and interview, it was determined the facility failed to ensure medical equipment and supplies were maintained to ensure an acceptable level of safety and quality for 3 of 5 (Physical Therapy, Respiratory Therapy and Emergency Department) patient care areas observed.

The findings included:

1. Review of the facility policy, "PREVENTATIVE MAINTENANCE PROGRAM" revealed, PURPOSE: To assure proper maintenance of equipment..."

2. Review of the facility contracts for Biomedical Maintenance for 2013 revealed, "[name of company] provides Perry Community Hospital the following biomedical maintenance services described below...Annual Electrical Safety checks on all units, Annual Preventative Maintenance on all units..."

3. Observations in the Physical Therapy (PT) Department on 11/3/14 at 10:30 AM, revealed a Hydrocollator with a yellow biomedical sticker dated 4/2012 with a documented next inspection due date of 4/2013.

Observations in the Respiratory Therapy (RT) Department on 11/3/14 at 10:40 AM, revealed Cardiac Monitor unit's #7 and #8 with a yellow biomedical sticker dated 4/2012 with a documented next inspection due date of 4/2013.

The Medical Records Director was present on the tour of the PT and RT Departments and observed the out of date biomedical stickers

4. Observations in the Emergency Department (ED) on 11/5/14 at 8:20 AM revealed one sized 3 laryngeal tube with an expiration date of 2/2014.

Observations in the ED on 11/5/14 at 8:20 AM revealed one sized 4 laryngeal tube with an expiration date of 9/2014.

During an interview in the ED on 11/5/14 at 8:25 AM, when the Registered Nurse (RN) was asked if the dates were expiration dates, she stated "That's [That is] what it looks like to me."