Securing refrigerated controlled substances in the pharmacy can be challenging, but storing these medications on nursing floors adds yet another layer of complexity. Many solutions are in place for ambient medications which reside in medication rooms out on nursing floors, such as automated dispensing cabinets, but refrigerated controlled substances are often left more vulnerable.
The Drug Enforcement Administration (DEA) states that controlled substances must be stored in a securely locked cabinet of substantial construction. This applies to ambient and refrigerated medications. The intent of the law is that these substances are adequately safeguarded. There are a few options for adding a layer of safety and security.
Refrigerated controlled substances inside of the central pharmacy should be guarded by a secured main entrance into the pharmacy. An additional security measure is required once inside of the central pharmacy.
Some pharmacies may have a locked room inside of the central pharmacy where they inventory and store strictly controlled substances. Only technicians and personnel with access to that specific room would have access to the controlled substances.
In addition, many pharmacies invest in a controlled substance system, sometimes referred to as a “narcotic vault,” which helps them comply with industry standards, secure and manage inventory, and automatically document dispensed items. These solutions streamline processes and provide added security. As for the controlled substances which need to be refrigerated in this setting, a compatible refrigerator door lock integrates with the controlled substance system and helps track access to the refrigerator.
Refrigerators located outside of the central pharmacy are often storing various refrigerated medications, controlled and non-controlled. Finding an effective solution for safeguarding these controlled substances can be extremely challenging for the pharmacy.
In a typical medication room there is an automated dispensing cabinet which provides similar efficiencies and safety measures as a controlled substance system. The automated dispensing cabinet can be integrated with the refrigerator via a remote lock. The automated dispensing system will control access to the refrigerator, but once access is granted and the refrigerated is unlocked, the nurse, or other personnel, will have access to the non-controlled medications, as well as the controlled substances.
For this reason, some facilities may choose to have a small refrigerator dedicated to controlled substances in the medication rooms, which is separate from the other refrigerator(s) used to store temperature controlled medications such as antibiotics, insulins, etc. Having a dedicated refrigerator for controlled substances in the medication room is an effective solution as it prevents personnel from being able to access controlled substances every time they retrieve a refrigerated drug stored in the medication room refrigerator.
If a dedicated refrigerator is not feasible, separate, individual, secure lock boxes are recommended for each controlled substance stored in the refrigerator. When more than one controlled substance medication is stored in a single locked storage box, daily inventory counts should be completed.
Keeping refrigerated controlled substances out on nursing floors provides many benefits as long at the medications are properly stored and secured. It can reduce the number of times the central pharmacy has to stock the medication rooms, cut down on time required to short-date the refrigerated medications, and improve efficiency overall. A dedicated, compact refrigerator that is able to integrate with the automated dispensing cabinets in the medication rooms is a great solution to balance the needs of the pharmacy and the nursing staff while meeting guidelines for the safe storage of refrigerated controlled substances.