Refrigerator Temperature

What are some general concerns regarding refrigerator temperature and monitoring?

Joint Commission standards do not specifically address use of refrigerators, whether for staff or patient use; however, there are some issues that affect refrigerators. Typically, the state department of public health has standards for patient refrigerators with which the Joint Commission expects compliance. Mixing staff and patient food in the same refrigerator is discouraged. Organizations should have policies that address temperature and cleaning of both staff and patient refrigerators. See also PC.7.10, EP 2. 

Medications may be stored in patient refrigerators, provided that they are separated (for example, in individual containers on separate shelves) and appropriately secured, as addressed in MM.2.20, EP 2.  The refrigerator must maintain appropriate temperature to ensure that the medications are not adversely affected. Typically, it is easier to have two separate refrigerators, one for general patient use and the second for medications. Medication refrigerators are often critical in maintaining an appropriate environment for various medications. Monitoring of the medication refrigerator is one method to ensure reliability and appropriate storage of medications.

Regarding monitoring and alarms: The patient and medication refrigerators must be operated in the appropriate ranges, and monitoring is one way to ensure compliance, as well as alert those responsible for maintaining the refrigerator. Alarms might be used in lieu of written records, provided that they are responded to appropriately.  For example, a local alarm in an area that is not attended to (for example, over a weekend) may fail during the weekend (for example, from a power outage) and have its power restored, all without the user being aware of the occurrence. Alarms that are monitored—with appropriate evidence of monitoring, such as documentation—would likely maintain compliance by ensuring appropriate temperature ranges.

If a lab specimen (for example, sputum or urine for urinalysis) is stored in a refrigerator on an inpatient unit, laboratory standards are applicable. The laboratory’s policy should define the storage temperature requirements, and the organization would have to follow its own policy. Daily recording of the temperature would be required and should be retained for two years.