Healthcare Inspection Review of Selected Pharmacy Operations in Veterans Health Administration Facilities

The purpose of our review was to: (1) evaluate pharmacy controls related to security and management of controlled substances (CS), (2) determine whether medical facilities complied with local and Veterans Health Administration (VHA) policies regarding pharmacy security and handling of CS, and (3) evaluate whether management controls of deterrence and detection of CS diversion were effective. We performed this review at 43 VHA medical facilities during Combined Assessment Program reviews conducted across the country from January 1–December 31, 2008. Overall, pharmacies complied with VHA and infection control guidelines, pharmacy physical security, and reporting requirements. However, improvement is required to ensure full compliance with VHA regulations regarding CS inspection programs. We made the following recommendations: Reinforce compliance with VHA regulations regarding CS inspection programs. Ensure that pharmacies review compliance with United States Pharmacopeia guidelines for compounded sterile products. Encourage facilities to provide guidance for clinical review of polypharmacy in high-risk populations, such as mental health patients and the elderly.