HospitalInspections.org

Based on observation, review of policy and staff interview it was determined the hospital failed to ensure medications were secured per policy. This was observed during one of two observations conducted on the General Rehabilitation Unit. This failure creates the potential for an adverse outcome for all patients and/or visitors. Findings are:

1. Observation on the General Rehabilitation Unit was conducted between 1620 and 1645 on 2/3/14. A medication cart (Team 5) was observed to be in the doorway of room 241. Both oral and injectable medications in sealed bags were found in the unlocked drawer. The nurse responsible for this medication was not present in the room nor could the nurse be found in the hallway.

The Chief Nursing Officer was present for this observation and agreed with this finding.

The policy "Medication Administration," last revised 6/13, was provided for review. The policy states in part: "Sealed bags are to be placed in locked medication cart and transported to the appropriate rooms for dispensing."