Unauthorized medication collections on inpatient units

Unauthorized medication collections (UMCs) on inpatient (IP) units represent a potential source of medication errors. UMCs are collections of medications not approved for storage and immediate access on IP units. We sought to establish whether UMCs were present on IP units in a suburban acute care hospital and to document the characteristics of any UMCs found.

In this descriptive study, we searched all of the IP units in the hospital for unauthorized medications. We checked all medications found against current ward-stock lists to determine whether they were authorized, and we classified unauthorized medications into the following categories: high-alert, easily confused, expired and improperly stored medications, and controlled substances. All unauthorized medications found in various locations on a unit were considered one collection. We counted the number of unique products and total number of medications and calculated the total dollar value of the medications in each UMC.

A UMC was found on each of the 17 IP units in the study hospital, resulting in a total of 656 unauthorized medications constituting 163 unique products. We documented high-alert, easily confused and expired medications and controlled substances. No unauthorized medications were improperly stored.

Investigations are needed to determine why these UMCs exist and to formulate mechanisms to eliminate them. Knowing that UMCs may be present, nurses should search their workspace and remove any UMCs they find. They should also examine their nursing practice to determine if they are contributing to this unsafe practice.