HospitalInspections.org

Based on observation and interview, the facility failed to ensure that outdated medications were removed from patient use areas for 1 of 2 emergency carts and 1 of 1 patient care rooms in the Medical Services Unit (MSU).

The findings are:
On 7/25/16 at 10:27am the Executive Nursing Director (END) for the MSU arrived to provide guided tour of the unit and access to the unit's medication storage areas.
At 10:44am review of the medication room and crash cart was conducted. The END stated that they were utilizing a new form and policy that required a nurse from each shift to verify the lock number on the emergency cart every shift and record it on the log. He stated that on each Friday, review of the crash cart was conducted by a nurse who would break the lock on the cart and review the contents of the cart for any supplies or medications that may be expired. Review of the log maintained by the staff showed that on Friday July 22, 2016 the lock on the cart had not been broken and replaced as scheduled. The END stated that the cart had not been broken until that morning on July 25, 2016. Review of the contents of the crash cart revealed two electrode patches that are used by the defibrillator that were out of their original package and in a Ziploc bag. There were two sets of replacement electrodes that were still in the original package with expiration dates of 2/2017. When asked how they would know the expiration date of the electrodes in the Ziploc bag, the END examined them and stated that they couldn't tell the expiration date and then removed the electrodes from the cart.
At 10:57am observation of the Emergency Room (ER) crash cart was conducted. The log of inspection maintained by the facility staff was reviewed and showed that review of the cart had been conducted every shift, but that on July 22, 2016 the nurse responsible for complete review of the cart had not broken the lock on the cart for inspection. The lock had not been broken until that morning on July 25, 2016.

At 11:04am review of the patient care emergency room area was conducted. There were also storage cabinets in the ER with baskets of various medications and some stock medications. Random review of these medications showed a 5ml vial of sterile water with expiration date of 06/2016.


36858

Based on observation and interview, the facility failed to ensure that food products were stored in a sanitary manner in 2 of the 11 facility coolers/freezers.

The findings are:
On 7/25/16 at 1:24pm entrance was made to the kitchen and tour began with the Dietary Director. At 1:32pm observation of the large outside freezer showed some scattered dots of ice on the ceiling, but no dripping water. The door to the freezer had not been replaced, but had been fixed so that it did seal. The door was still observed to be scrubbing the concrete floor when opened or closed. There was a large fan unit on the right of the freezer wall with four fans running. The fans unit was observed to have some ice build-up on it and along the pipe that was running from the fans unit and along the wall of the freezer. There were multiple boxes of food products observed to be on pallets under the fans unit. Two of these card board boxes were slightly opened and had large ice particles of non-potable water on top of them. Review of the contents of these two boxes showed plastic bags of chicken nuggets. The plastic bags were not sealed and the food product was exposed. The Dietary Director had staff remove these boxes of nuggets and discard them.
At 1:38pm observation of the production freezer showed a box of frozen, breaded fish portions in a card board box. The box was smashed and flipped on its side and fish portions were observed spilling out of the box and onto other boxes of food product that was under it.
On 7/27/16 at 9:13 am entrance was made to the kitchen and a subsequent tour was conducted with the Dietary Director. Observation of main freezer located outside the kitchen showed all food products had been moved from under fan unit. At the time of the observation, the door to the freezer was observed to be standing wide open with pallets of food product lining the wall around the freezer. There were two employees observed inside the freezer, unloading boxes from the pallets and onto the shelves within the freezer. There was a significant amount of condensation observed within the freezer to include the ceiling and walls of the freezer. There was accumulated ice made of non-potable water observed on the fan unit and on some of the tubing on the wall of the freezer near the entrance door. The ice was observed to be melting and dripping from the heat outside of the freezer. Outside temperature at the time of the observation was 81 degrees with 81% humidity, making it feel like 88 degrees according to The Weather Channel.

Interviews were conducted with the Dietary Director during both tours of the kitchen. She confirmed findings of contaminated food products and inappropriately stored food items in the facility freezers.On 7/27/16 she acknowledged that the way foods were being unloaded in the freezer with the door open was not the apporpiate method for maintaining freezer temperature and preventing the accumulation of condensation and melting ice within the freezer