Is it acceptable to position emergency carts secured with a breakaway lock in strategic locations, such as a trauma room in an emergency department or an alcove on a nursing unit or any area staffed 24/7 even though these carts may not be under constant visual surveillance by staff 100 % of the time ?

Since emergency departments and nursing units are staffed 24/7, yes, it would be acceptable to place emergency carts^ in these locations as long as there was a defined process in place to monitor the integrity of the breakaway lock and cart contents. Constant visual surveillance of emergency carts is not required when such systems are in place. However, if there is evidence of tampering or diversion, or if medication security otherwise becomes a problem, the hospital is expected to evaluate its current emergency cart security policies and procedures, then implement the necessary systems and processes to ensure that the problem is corrected, and that patient health and safety are maintained. NOTE: Emergency carts containing medication located in departments that are not staffed 24/7 must be secured in a locked location.