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A surprise CMS visit puts patient safety in the spotlight

Accreditation Connection, January 6, 2005

Patient safety dominated a surprise Centers for Medicare & Medicaid Services (CMS) survey recently when surveyors combed Marshalltown (IA) Medical and Surgical Center (MMSC) for expired medications. The July survey was one of the most intensive surveys that the 100-bed hospital has ever experienced, says LaRae Schelling, RN, CPHQ, vice president of operations and chief nursing officer at MMSC.

For three days, surveyors made the rounds, observing staff while they administered medications and changed dressings. The surveyors also examined open and closed patient records and questioned staff about medication security and fire and chemical safety.

The surveyors included five nurses, a dietician, and a state fire marshal. They asked the following questions about medication security:

• Is this drawer always locked?
• Is the nurses' station constantly attended?
• What do you do with the crash cart after hours?

The few expired medications in drawers in the emergency department and operating room weren't enough for surveyors to cite the hospital for noncompliance, says Barb Grabenbauer, RN, patient safety director.

By coincidence, MMSC held a staff contest several weeks prior to the CMS survey, rewarding the person who found the most expired medications. The contest inspired staff to sweep the hospital and check remote areas. As a result, every clinical department submitted a sack that contained from one to two dozen expired medications.

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