Other things we do that place your health at risk.

Other things we do that place your health at risk.

 

1)  All vaccines and temperature-sensitive medications that require refrigeration should be stored in refrigerators with continuous temperature monitoring that alarms and records when temperatures fall out-of-range - and for how long.

-  A digital or manual log of out-of-range temperatures needs to be reviewed on a regular basis by the Pharmacy Department and maintained.

-  This log should also include actions taken for each out-of-range temperature.

-  Some vaccines require frozen storage, but the aforementioned requirements should also apply.

-  Deviation from the required storage conditions for any medication or vaccine can reduce or eliminate their effectiveness.

-  Not all hospitals follow these important principles of maintaining AND monitoring storage conditions for medications and vaccines – especially outside of the central Pharmacy where medications and vaccines are stored at the point-of-care.

 

2)  Hospitals should maintain policies and procedures that outline actions to be taken for deviations from the required storage conditions in both the central Pharmacy Department and point-of-care areas.  These actions should include all possibilities up to and including the disposal of medications and/or vaccines.

-  Many hospitals do not have these policies and procedures.

 

3)  Food and food products should never be stored in a medication refrigerator.  Foods, and even the outside of food containers, provide an ideal environment for the growth of bacteria.

-  Some hospitals and/or point-of-care areas store drinks, pudding, yogurt, applesauce, etc. (that are used to administer medications to certain patient populations) in medications refrigerators for the sake of convenience.

 

4)  Refrigerators used for the storage of microbiology specimens (and other specimens) in the central Laboratory and in point-of-care areas must be separate and have the same requirements for maintaining and monitoring storage conditions, as well as policies and procedures outlining actions to be taken for out-of-range temperatures – up to and including the disposal of specimens.

 

 

5)  Refrigerators used for the storage of blood or blood products (for transfusion) in the hospital’s Blood Bank and in point-of-care areas must be separate and have the same requirements for maintaining and monitoring storage conditions, as well as policies and procedures outlining actions to be taken for out-of-range temperatures – up to and including the disposal of blood or blood products.

 

 

6)  Hospitals need to have a process for monitoring and auditing compliance with required storage conditions for medications, vaccines, microbiology specimens, and blood/blood products.

 

- Public Health Departments, government/regulatory agencies, and Accreditation Canada all need to audit these practices during their inspections.

 

-  Logs need to be reviewed spanning back to the previous visit (i.e previous Public Health inspection or Accreditation Canada survey).

 

And on a slightly different note….

 

7)  All intravenous (IV) lines attached to a central venous line (CVL) must run via an infusion pump to prevent the risk of (life threatening) “air embolus”.

-  IVs connected to CVLs should never be run via gravity.

-  Sometimes an infusion pump is not in the room when a CVL is inserted in an emergent situation.

-  Simply bumping an IV bag around can let air into the tubing – that you may not notice during a crisis situation.

-  Infusion pumps need to be considered part of the equipment necessary for central line insertion.

-  Infusion pumps have air-detectors and will alarm and stop infusing if air is detected.