Medication Storage

If you have taken my Initial Certification Class for RCFE Administrators, you know we spend a good amount of time talking about medications. Meds are SOOOO important to get right in our facilities. One of the biggest challenges smaller facilities have is the storage of medications.

Title 22, Section 87465, tells us that "medications must be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication." So where do we find this great safe location?

Well, a number of facilities choose to use a coat closet and convert it to their meds storage area. They take out the hanging bar, add in some shelves, and use cute little baskets or plastic shoe boxes, one per resident. The plastic shoe boxes work well because you can also stick the residents picture on there and use a label-maker for their name for easy identification. While I absolutely love this idea, its not always possible for everyone.

You may have limited linen closets and need to use those for things like... well, linens. Some facilities have been using a kitchen cabinet, which I am hearing more and more LPA's are finding issue with, since that is a kitchen area, where food is kept. They quote that medications shall be stored separate from food, which includes "food areas." So you may want to be prepared if this is where you are keeping your meds.

If you are still using this method, please make sure that that cabinet is always under lock, like the picture to your right, unless being actively used by your staff. In a previous post I mentioned ways to keep cabinets locked up, you can check that out by clicking the back button and scrolling down to "Keeping Your Kitchen Cabinets Safe." Or just click on the link to get straight to it.

What other options do we have? How about med carts! The large facilities have those big fancy med carts that either provided to them by their pharmacy or purchased on their own, but those are too big for our smaller facilities. Something you can look into are toolboxes on wheels. You can find these at Home Depot, Lowes, ACE hardware, Harbor Freight, Walmart, Amazon, etc. Look for one that has at least 6 drawers (for a 6-bed facility) and locks. This is an awesome solution if you are limited on closet space, because the med cart can be housed in an empty corner, moved around if you need to take meds down the hall to a resident, and taken out of the building in case of an emergency and all meds will stay in their separate drawers nice and secured. I first saw the rolling toolbox in a facility in Thousand Oaks and fell so in love with the idea I have talked about it in every med class. The blue med box linked above has 7 drawers, and you are free to organize things however you see fit. You could use the top drawer for your Centrally Stored LIC622s, MAR binder, tablet or laptop if you're doing EHR, and the drawers one per resident, you could split the bigger drawers with an organizer so its two residents per drawer and then space for overflow or house supply, etc.

One of my recent CEU students shared what her facility does along the same lines - they use a hairdresser cart. It is also on wheels and locks for safety, but its much lighter and smaller than a toolbox and takes up less space. The staff love this in her facility because they have a few residents who are bed-bound and the med techs can easily roll this from one side of the facility to the other.

What about meds that need to be refrigerated or things like Ensure? Well, if you JUST read the regs, you will find a line that says something along the lines of "medications that require refrigeration must be kept in a container separate from food items." So looking at that, you can say well, I can have my refrigerated meds in this little box, and right next to it are my veggies.

However that may not be how your LPA is interpreting that regulation. They also have a document that states the medication refrigerator must be 36-46 degrees Fahrenheit. So my suggestion is, stay ahead of your LPA, don't risk a deficiency, and just have a separate meds refrigerator from the very beginning.

You can get a small dorm room fridge and a separate lock if you're working on a budget, as most of us are. Please make sure you do NOT have a sticky note with the code clearly visible. I know this sounds silly, but I have walked into facilities where I have seen this with my own eyes. If your LPA sees this, you may be getting a deficiency.

If you happen to have a number of residents who have medications that require refrigeration, or a few that are taking Ensure, or whatever other reason you need a slightly larger fridge, there are plenty of options that may suit your needs, like the example here.

Oh speaking of Ensure, please make sure you label EVERY can. Just use a sharpie to write the residents' name and room number. And of course don't forget to have that physicians order on file. One facility got a deficiency for just having it on site while waiting for the doc to call back with the order. Ugh!

If you would like to get a little more fancy, you could get a refrigerator with a built in lock. It looks so clean right? These are more expensive than the simple dorm fridge, but they sure look nicer than the lock sticking the door and side.

Don't forget to have a thermometer in your kitchen fridge AND your meds fridge, because your LPA will be asking how you know what the temperature is, and you can keep a simple log that your staff mark off however frequently you like - once a day at night shift is a good option, but train all your staff to glace at that thermometer each time they open the door. This way, just in case the temp is off, we can catch it quicker than just night shift, or however often you check and log.

The snapshot of the log to your right is a simple template you can recreate yourself. Keep this somewhere near the refrigerator, maybe hang it on the side with a magnet, or keep a clipboard with the log. On second thought, you may want to pre-populate when you want your staff to check the temps like the log below.

I have some additional items for you to check out, since we're on the topic of meds. I know this post is getting a little lengthy, so we will keep it to the links and bullet points.

As always, all pictures (except the logs examples) are links to Amazon products. As an Amazon Associate I get commissions from sales, so help a girl out, use my links to place your orders.