Health and safety
Medication Storage and Cold Chain Checklist
- Who checks
- Head nurse or the person responsible for medication storage
- When
- Weekly; temperature readings daily per the clinic schedule
- Time
- ~40 min · 30 items
| Location | Date and time | Inspector | Signature |
A medicine that has been stored at the wrong temperature or past its expiry date looks exactly like a good one. That's why storage is checked through indirect but reliable signs: temperature logs, labeling of opened packs, order on the shelves, and stock matching the records. Pay special attention to the cold chain: temperature-sensitive medicines are usually stored at 2–8 °C (36–46 °F), and any excursion must not only be noticed but documented.
Start with the room and cabinets, then fridges, expiry dates and stock records. Take storage conditions for each product from the manufacturer's instructions and requirements for controlled drugs from the law in your country. Fix cold chain and expiry issues during the audit itself.
Storage room and cabinets
-
1
Medication cabinets and the storage room are locked Cabinets are locked; keys are with the responsible person or in a designated place, not left in the lock.☐ Yes☐ No
-
2
The storage area has a thermometer and hygrometer Instruments hang on an interior wall, away from heaters and windows; readings are legible.☐ Yes☐ No
-
3
Room temperature in the storage area, °C Record the thermometer reading and compare it with the storage conditions in the product instructions.
-
4
Humidity in the storage area, % Record the hygrometer reading.
-
5
Temperature and humidity are logged for every working day Open the log for the last 2 weeks: no gaps, entries made at different times rather than filled in afterwards in one handwriting.☐ Yes☐ No
-
6
Medicines are not stored on the floor, near radiators or in direct sunlight Boxes are on shelves or pallets; no sunlight from the window falls on the cabinet.☐ Yes☐ No
-
7
Medicines are grouped and shelves are labeled The layout follows the clinic's scheme; products for external use are stored separately from the rest.☐ Yes☐ No
-
8
Disinfectants and cleaning products are stored away from medicines No disinfectant canisters or cleaning products in the medication cabinets.☐ Yes☐ No
Refrigerators and cold chain
-
9
Current temperature in the medication fridge, °C Record the reading of the reference thermometer or data logger; the target for temperature-sensitive medicines is 2–8 °C. Photograph the reading.
-
10
The medication fridge contains no food, specimens or reagents Only medicines inside; lab samples and staff food are kept in other fridges.☐ Yes☐ No
-
11
Fridge temperature is recorded as often as the clinic requires Open the log or logger download for 7 days: entries follow the schedule (often twice a day) and are signed.☐ Yes☐ No
-
12
The reference thermometer sits on a shelf with medicines, not in the door The thermometer or logger probe is in the middle of the compartment, next to the medicines.☐ Yes☐ No
-
13
The thermometer or data logger has current calibration There is a certificate or label with a date that has not expired, per your country's requirements for measuring instruments.☐ Yes☐ No
-
14
Medicines are not stored in the door or pressed against the back wall There are gaps between packs and walls for air circulation; no packs frozen to the back wall.☐ Yes☐ No
-
15
The fridge is protected from being accidentally unplugged The plug is not in a switched power strip shared with other devices; the outlet is labeled "Do not unplug."☐ Yes☐ No
-
16
Ice packs and a cool box are ready in case of a power outage Ice packs are frozen in the freezer and the cool box is clean and in a known place; ice packs are conditioned per instructions before packing so medicines don't freeze.☐ Yes☐ No
-
17
The procedure for temperature excursions is available to staff Instructions are posted next to the fridge; ask a nurse what she would do if the reading were 10 °C — the answer matches the instructions.☐ Yes☐ No
-
18
Every temperature excursion in the past month is documented with the action taken Each out-of-range entry in the log has a note: what was done with the medicines and who made the decision.☐ Yes☐ No
Expiry dates and labeling
-
19
No expired medicines on shelves or in fridges Check 10 packs in different cabinets, including back rows and bottom shelves.☐ Yes☐ No
-
20
Short-dated medicines are at the front and marked First-expiry, first-out is followed; products with a short remaining shelf life carry a sticker.☐ Yes☐ No
-
21
Opened vials and solutions are labeled with the date and time of opening The in-use period after opening per the manufacturer's instructions has not been exceeded.☐ Yes☐ No
-
22
Expired and rejected medicines are quarantined until disposal They are in a separate labeled area or a "Do not use" box, not on the working shelves.☐ Yes☐ No
-
23
Look-alike, sound-alike medicines are separated and flagged Similar products are not stored side by side; their shelves carry warning labels.☐ Yes☐ No
-
24
All medicines are kept in packaging with legible labels No tablets or solutions decanted into unlabeled containers; name, strength and expiry date are readable.☐ Yes☐ No
Stock records and controlled drugs
-
25
Controlled drugs are kept in a safe The list of controlled drugs and the requirements for the safe and room are set by the law in your country; the safe is locked.☐ Yes☐ No
-
26
Controlled drug stock matches the register Count 3 items together with the responsible person: the physical quantity equals the balance in the register.☐ Yes☐ No
-
27
Handover of the safe keys is recorded Keys are held by the designated person; every handover between shifts is logged with signatures.☐ Yes☐ No
-
28
Stock of other medicines in the system matches the physical count Check 5 random items; any variances are explained and documented.☐ Yes☐ No
-
29
Cold chain compliance is checked when temperature-sensitive medicines are received Paperwork for the last 3 deliveries records the delivery temperature or the indicator reading in the cool box.☐ Yes☐ No
-
30
The person responsible for medication storage is formally appointed The appointment is signed and the employee knows about it; each clinic in the group has its own responsible person and deputy.☐ Yes☐ No
This template is a starting point. Check the limits and wording against your local regulations, your company standards and the equipment manufacturers' instructions.
jeCheck · https://jecheck.io/en/templates/clinic-medication-storage
Common violations
- Medicines are pushed against the back wall of the fridge or kept in the door — at the wall they can freeze, and in the door they warm up every time it's opened.
- The temperature log is filled in after the fact with "normal" readings — a real excursion after a power cut goes unnoticed and damaged medicines are used on patients.
- Medicines share a fridge with staff lunches or specimens — that's a mix-up risk, and frequent opening makes the temperature swing.
- An opened vial has no opening date — nobody can tell whether its in-use period has expired, and it gets used on guesswork.
- Expired packs sit on the same shelves as usable stock "until disposal" — sooner or later someone picks one up by mistake.
Frequently asked questions
The frequency is set by internal procedures and local requirements; common practice is at least twice per working day. A continuous data logger makes it easier, but its downloads still need to be reviewed and signed regularly.
Follow the clinic's written procedure: record the time and reading, move the medicines to a working fridge or cool box, quarantine them pending a decision by the responsible person, and check with the manufacturer or supplier whether they can still be used. Everything is recorded in the log.
A formally appointed employee, usually the head nurse; each clinic in a group needs its own responsible person and a deputy for holidays. The weekly audit is usually assigned to them, and a monthly spot check to the group's chief nurse.
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