| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 11/17/2011 |
| Name of Provider or Supplier Crook County Hospital | Street Address, City, State 713 Oak Street, Sundance, WY | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| C0276 | PATIENT CARE POLICIES CFR(s): 485.635(a)(3)(iv) [The policies include the following:] rules for the storage, handling, dispensation, and administration of drugs and biologicals. These rules must provide that there is a drug storage area that is administered in accordance with accepted professional principles, that current and accurate records are kept of the receipt and disposition of all scheduled drugs, and that outdated, mislabeled, or otherwise unusable drugs are not available for patient use. This STANDARD is not met as evidenced by: Based on observation, staff interview, and review of policies and procedures, the facility failed to ensure medications were administered as ordered, the physician was notified and subsequently verified or changed questionable orders, or that errors were reported appropriately. These failures affected 8 of 22 sample patients (#2, #4, #9, #10, #12, #14, #15, #18). In addition, the facility failed to ensure medications were properly secured in the emergency department and that expired medications were not available for patient use. The findings were: 1. Refer to C297 for evidence the facility failed to ensure medications were administered as ordered and that questionable orders were verified or changed. 2. Refer to C277 for details related to failure to report medication errors. 3. Refer to C224 for information related to failure to comply with the policy and procedure for medication storage in the emergency department. 4. According to the facility's policy and procedure "Labeling and management of outdated drugs" last revised 6/1/08, "All expired drugs will be removed from the shelf..." Failure to adhere to this policy and procedure was identified as follows: a. Observation on 11/15/11 at 7:50 AM with RN#10 revealed the following expired medications were available for use: 1. An unopened vial of Procrit Epoetin Alfa, forty thousand units, was in the medication room labeled "expired September 2011." 2. An opened and partially consumed container of liquid labeled "10% cocaine/ sodium chloride mixed on 11/10/10" was in the medication cart. Interview with the RN at that time revealed staff did not know whether or not the mixture was "good." b. Observation on 11/15/11 at 2:05 PM with LPN#1 revealed the following expired medications were available for use in the pharmacy medication storage room: 1. Twenty-five vials of 10% calcium gluconate, one hundred mg, labeled "expired October 2011." 2. Seventeen 5 mg prednisone pills labeled "expired September 2011." At that time the LPN stated the outdated medications should have been removed from the storage shelves, and she had no explanation for why it had not been done. 27095 |