Medicine storage
Take a chill pill: safe and effective medicine storage
Colin Burgess, senior technical manager for medical refrigeration specialist Lec Medical, outlines the regulations governing the storage of ‘cold chain’ medical products and explains how care homes can meet the highest safety standards without placing an undue burden on staff
Safe storage is a central plank of all guidance on the management and administration of vaccines and medicines within a care home setting. Government guidelines state that: “As a minimum, training for care home assistants should cover: the supply, storage and disposal of medicines; safe administration of medicines; quality assurance and record- keeping; and accountability, responsibility and confidentiality.”1
The pressure on care home staff to adhere to policies and procedures relating to drugs is rightly high, in order to protect vulnerable residents with often complex health needs. It is also understandable that staff might prioritise how drugs are given to residents, while paying less attention to how those drugs are stored. However, incorrectly stored medicines can threaten the health of residents as much as administering them inaccurately. And if an entire batch of medicines is stored in unsafe conditions, it could impact the
health and safety of far more people. Additionally, if sensitive pharmaceutical products are left in conditions which are too hot or too cold, the potential damage caused can render them ineffective and they must be discarded. The financial implications of this are serious, particularly at a time of ongoing cost pressures across the care sector.
Why is correct medicines storage important?
A number of drugs administered in care homes are temperature sensitive. Typical examples include flu and COVID vaccines, insulins, antibiotics, cancer drugs, anti- inflammatories, and glaucoma and other eye or ear drops.
These are considered ‘cold chain’ products, which means they must be kept in stable refrigerated conditions at temperatures between 2°C and 8°C from the point of manufacture until they are administered to the patient.
If cold chain medicines are stored outside the required temperature range, the active chemicals in them can change in molecular form. This can cause them to become less effective and to degrade more quickly, rendering manufacturer ‘use by’ dates defunct. An easy visible example is an ointment that has gone off-colour and runny, or a gel capsule that has hardened or softened, making it obvious that they should not be used. However, it is not always so simple.
For example, vaccines are probably the most temperature-sensitive cold chain drugs. They are highly sensitive biological substances which contain antigens – living organisms from viruses and bacteria – which means they gradually biodegrade over time. Storing vaccines outside their
recommended temperature range can speed up their natural loss of potency. This impact cannot be reversed, and a vaccine may then fail to create the desired immune response and give protection. The Public Health Agency and Health and Social Care Board advise that if vaccines are stored outside of the recommended 2–8°C for longer than just 20 minutes, this is considered as a significant cold chain breach and immediate action is required.
CQC guidance on storing medicines It is clear that temperature is one of the most important factors that can affect the stability of a medicine, and the CQC has issued specific guidance for care homes relating to cold chain medical products. It is unequivocal about the type of
refrigerator where cold chain products should be stored. It stresses: “Dedicated medicines fridges should be of a suitable standard to keep medicines at
February 2025
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