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Based on observation and interview, the facility failed to ensure that toxic chemical cleaning solutions were stored in a safe manner. This had the potential to affect any patients and visitors who may be at the hospital.

The findings include: The facility failed to store cleaning solutions in locked cabinets.

During an environmental tour with the Environmental Services Director on 6/22/10 at 1:25 p.m., it was observed that cleaning solutions were available for use in the soiled utility rooms in the inpatient care areas. The following products were observed to be stored unsafely: there was 1 spray bottle of Neutral Quat Disinfectant and 1 container of PDI Sani-Cloth Germicidal Wipes stored on the counter in the obstetrics (OB) unit soiled utility room. In the OB unit's clean utility room, there was another spray bottle of Neutral Quat Disinfectant stored under the hand sink in an unlocked cabinet. In the kitchen on the OB unit there was another spray bottle of Neutral Quat Disinfectant under the sink in an unlocked cabinet. In the soiled utility room by Station #3, there were 3 spray bottles of Neutral Quat Disinfectant and a spray bottle of bleach disinfectant. In the radiology department, there were 4 containers of Mertricide disinfectant stored in an unlocked cabinet under the sink. The doors to this room were open and there was not always supervision of the area. In addition, there was a spray bottle of Neutral Quat Disinfectant stored on a shelf in the hospital storage/supply room which was not always supervised.

Material Safety Data Sheets (MSDS) were reviewed for each of these products. The MSDS information verified that the Sani-cloth products could be harmful if ingested, could cause skin and eye irritation and could be irritating to the respiratory system. The MSDS sheets for the Neutral Quat Disinfectant indicated that the product could cause chemical eye and/or skin burns; could be harmful or fatal if swallowed; and could cause central nervous system depression. The MSDS sheet for the bleach disinfectant indicated that product could cause moderate eye irritation and gastrointestinal irritation and upset. The MSDS sheet for the Mertricide indicated the product could be corrosive to exposed tissue, and could cause eye damage and skin irritation.

The Environmental Services Director confirmed these findings at the time of the tour and stated the products should have been stored securely.

Based on observation, interview and policy review, the facility failed to ensure that medications and medical contrasts were stored securely in the radiology and emergency room departments. This had the potential to affect any patients and/or visitors who may receive services from the hospital.

The findings include: During a tour of the radiology department 6/22/2010 at 8:25 a.m. with the Director of Radiology, it was noted that there were unsecured medications/contrasts stored in unlocked cupboards in X-ray room #1. These medications included: Barium Sulfate 98% 340 grams of dry powder; 3 containers of Barium Sulfate 41% 355 milliliters (ml); Esophageal Barium cream 2 tubes (230 ml size) 40% paste; and a total of 16 enema bags of 99% Barium. In addition, there was a supply of emergency medications stored in a small metal drug box in an unlocked drawer marked "Drug Reaction Box".

During a tour of the emergency room (ER) on 6/22/2010 at 4:30 p.m., a cart containing a variety of emergency medications was noted to have been unlocked and without direct supervision. The emergency room was only staffed when patients were present and the doors to the hallways were not locked.

The unlocked medication cart in the ER included: 3 vials of Amiodarone 150 mg; 2 vials of Dopamine 400 mg; 500 cc bag of premixed Heparin; 500 cc bag of premixed Lidocaine; 50 mg Nipride; Premixed bottle of Nitroglycerin; 100 mg bottle of Activase; Solucortef 100 mg; and a vial of Benadryl.

The Assistant Director of Patient Care Services confirmed on 6/22/2010 at the time of these observations that these medications could be more securely stored and verified that the ER doors were not always locked and the ER was not staffed at all times.