HospitalInspections.org

The hospital reported a census of 3 acute patients. Based on observation, document review, and staff interview the hospital failed to ensure outdated medications were unavailable for patient use in 3 of 3 emergency crash carts used for patient emergency care.

Findings include:

- The hospital had three crash carts (used for emergency, life-threatening patient care) and were opened to survey contents. Outdated medications were found in three of three crash carts surveyed as follows:

1. Emergency Department observation on 9/10/12 at 11:30am revealed the following expired Medications available for patient use:
1. One vial of Lidocaine 2%, expired on 8/1/12.
2. One vial of Dobutamine 250mg (milligrams), expired on 8/1/12.
3. One vial of Adenosine 6mg, expired on 6/12.
4. One vial of Diazepam 10mg, expired on 9/1/12.
5. Three bottles of Pedilyte, expired on 8/1/12.

2. West hall crash cart (used for the acute care hall 200) observed on 9/10/12 at 1:00pm revealed the following expired medications available for patient use:
1. One vial of Dobutamine 250mg (milligrams), expired on 8/1/12.

3. East crash cart (used for surgery rooms and acute care hall 100) observed on 9/10/12 at 12:30am revealed the following expired drugs available for patient use:
1. One vial of Dobutamine 250mg (milligrams), expired on 8/1/12.
2. One vial of Adenosine 6mg, expired on 6/12.

- Hospital policy for authorized area- outdated or unusable drugs directed staff to remove all outdated drugs and return the drugs to the hospital pharmacy.

- Administrative staff B interviewed on 9/11/12 at 8:30am verified all expired medications should be removed and taken to the pharmacy on the monthly basis.

The hospital reported the surgical department performed both in-patient and out patient surgeries. Based on observation, staff interview and record review the Hospital failed to ensure the two operating rooms (OR's) and the five nursing staff in the surgical department were supervised by a registered nurse (RN).

Finding include:
- Observation on 9/12/12 at 9:00am revealed licensed practical nurse (LPN), staff N, introduced as the supervisor of the OR.
- Review on 9/12/12 at 1:15pm of staff N personnel file revealed staff N's LPN position included supervisor of the operating room.
- Staff S interviewed on 9/12/12 at 1:35pm acknowledged staff N is the designated OR supervisor. Administrative staff verified staff N supervised the OR under an LPN licensure.