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'Secure' Need Not Mean Locked

Cheryl A. Thompson

Contrary to popular belief, a "secure drug supply" does not, in the view of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), necessarily involve a lock system.

Medications other than Schedule II controlled substances can be securely stored by keeping them in an area under constant supervision, according to a "quick tip" in JCAHO's monthly news brief Inside Perspective. The March 1999 issue offered the constant-supervision approach as an alternative to locked cabinets and carts but cautioned against lapses in supervision. 

If a hospital decides that a nurses station can provide the constant supervision stipulated in the JCAHO standards, and a surveyor learns that occasionally no one is at the station, the hospital will receive a type I recommendation. Policies and procedures count, too. During the document review session, a surveyor will review the hospital's policies and procedures for securing emergency carts and medications. 

JCAHO offers specific guidance on securing drugs that have been prepared for use by anesthesia personnel and placed on the anesthesia cart in the operating room. These drugs are considered "secure" while the anesthesiologist or nurse anesthetist is away to bring the patient to the operating room. JCAHO reasons that, in the absence of evidence to the contrary, the drugs on the cart are not readily available to people other than the operating room personnel, according to the November 1999 issue of Inside Perspective

Current and back issues of Inside Perspective can be found at