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S E P T E M B E R 2 0 1 5 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
the combination's numbers on the
keypad lock were worn from frequent
use. Then there's always the possibili-
ty that a manager with approved
access to controlled substances
absentmindedly shares the combina-
tion with a staff member. Changing a
lock's combination a few times a year
will help limit the risks of these
potential security breaches.
Daily counts?
Two staff members must perform daily counts to ensure all con-
trolled medications are accounted for. One nurse performs the actual
count of vials in storage, stating the drug name and quantity, and the
second nurse confirms that the day's count coincides with the perpetual
count.
Staff members should conduct counts of controlled substances first
thing in the morning and at day's end, but do they perform them with
the needed focus each time? Staff are understandably busy in the morn-
ing preparing the facility for cases and they're likely anxious to tie up
loose ends and head home at the end of the day. Narcotic counts,
because they're often the same each day, might be where they cut cor-
ners. But haphazard inventory checks will eventually lead to trouble.
I've heard nurses say they've assumed all vials of a rarely used drug are
present and skip the actual count, only to find out one's been missing
for who knows how long.
Limited access?
Policies for controlling access to controlled substances will differ
2
3
z 4-3-2-1 Secure
anesthesia work-
rooms or drug stor-
age cabinets with a
combination lock.
Margaret
Sherman,
RN,
BSN
