HospitalInspections.org

Based on observation, review of facility policy, and staff interview, the Critical Access Hospital (CAH) failed to ensure removal of outdated intravenous (IV) fluids in 1 of 1 closet where staff stored IV fluids (closet across from nurses station). Failure to remove outdated IV fluids may result in patients receiving expired and/or ineffective fluids.

Findings include:

Review of the policy "Outdated Medications" occurred on 10/03/16. The policy, dated 09/02/16, stated, "POLICY: to outline the inventory management system that ensures outdated drugs and biologicals are not available for patient use. PROCEDURE: 1. Every month an inventory will be done by the Nursing staff to check the medications and biologicals for outdates. . . . 3. the outdated medications will be removed from the shelves where they are located and shall be returned to the Pharmacist for removal."

Review of medication and IV solution storage areas occurred on the morning of 10/03/16 with an administrative nurse (#1). Observation in a storage closet at 11:35 a.m. revealed the following outdated IV fluids available for use:
* Dextrose 5% with Sodium Chloride (NaCl) 0.33%: nine 500 milliliter (ml) bags - expired July 2016
* Dextrose 5% with NaCl 0.2%: nine 1000 ml bags - expired July 2016
* Dextrose 5% with NaCl 0.45%: one 1000 ml bag - expired November 2015, one 1000 ml bag - expired June 2016, and four 1000 ml bags - expired July 2016

During an interview, on 10/03/16 at 11:35 a.m. an administrative nurse (#2) confirmed the fluids had expired and removed them from the shelves.