Archived Content from National Patient Safety Week #4

Medication Storage
Reducing the risk of retrieval errors, theft and damage 

Q:  Secure medication storage is critical to safe, high-quality health care ... If concentrated electrolytes are present on patient care units, what can you do to help decrease risk?


A:  There should be limited access to the medications, special warning labels should be placed on the products, and they should be segregated from other medications that are directly administered.

Secure medication storage is critical to safe, high-quality health care for many reasons:

• If medications are not stored properly, they may become chemically unstable and present a health hazard to both patients and staff.
• The way medications are stored can increase or decrease the potential for medication retrieval errors.
• If medications are not properly secured, an organization introduces the opportunity for theft, which in some cases can have tragic consequences.
• Improper storage can also lead to inadvertent mix-ups with medications. Although not required, by segregating look-alike and sound-alike drugs, organizations can help prevent patients from receiving the wrong type of medicine.
• By limiting multiple concentrations of medications in a facility, organizations can help prevent patients from receiving the wrong concentrations of medicine.
• By eliminating concentrated electrolytes from care units, organizations can prevent potentially lethal medication errors.

• Ensure they are familiar with the hospital's procedures for recalled, expired, damaged, or contaminated medications.
• Store medications securely.
• Securely store controlled substances, especially narcotics.
• Segregate look-alike, sound-alike drugs to prevent errors (not specifically required). This may include segregating the medications using separate boxes, different shelves, different cabinets, or the door versus a shelf in a refrigerator or freezer.
• Standardize and limit drug concentrations. This may include using preprinted dosing charts for nurses to use with standard concentrations of the most common critical care and pediatric infusions.
• Remove concentrated electrolytes from patient care units unless you have shown that the presence of one of these products is an absolute requirement for safe patient care, such as in cardiac surgery and dialysis units. If concentrated electrolytes must be available on a patient care unit, there should be limited access to the medications, special warning labels should be placed on the products, and they should be segregated from other medications that are directly administered.
• Inspect medication storage areas, including refrigerators, freezers, crash carts, trauma kits, and floor stocks. Look at temperature (routine checks with interventions when temperatures are out of designated range), lighting, humidity, ventilation, cleanliness, and security issues when inspecting these areas.