10 ways to prevent drug diversion

Accreditation Insider, September 6, 2016

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Preventing the theft of controlled substances at hospitals continues to be an issue even with increased security measures. Failed drug diversion programs in hospitals have led to record fines levied against facilities. The Mayo Clinic experienced a highly publicized case of drug diversion back in 2008, where a nurse was caught stealing fentanyl from patients about to have a catheter inserted. The incident prompted the Mayo Clinic to take proactive steps toward drug diversion, such as:

1.    Having a zero tolerance policy for theft of any drugs from anywhere
This includes workers who fail to properly witness a coworker disposing a drug that is not ultimately given to the patient. Workers should be given pre-employment drug screening and receive education on the dangers of drug addiction and misuse.

2.    Work with law enforcement agencies
This includes local police and U.S. Drug Enforcement Administration (DEA). Officials from these agencies can process search warrants of employees' homes and cars to help prove a case. This also lets other facilities know whether a prospective job hire has been caught trying to steal drugs before.

3.    Employ a 24-hour diversion hotline for workers to report suspicious behavior
Place advertisements for the hotline around the facility and make sure that those working on the hotline are qualified.

4. Assemble a drug diversion intervention and response team
This includes a full-time Medication Diversion Prevention Coordinator, who is either a pharmacist or a certified pharmacy technician. The coordinator conducts educational campaigns, supervises drug diversion intervention and response team (D-DIRT) activities, and helps investigate case reports.

5.    Employ a waste retrieval system everywhere injectable opioids are used in patient care
This requires a strict policy that any drugs that have been taken out but not used be returned to a Class 2 controlled substances vault in the pharmacy, under the watch of cameras, for reconciliation with both the Pyxis and anesthesia records.

6. Throw out assumptions about drug diversion behaviors and perpetrators:
• They are NOT easily noticed because of their odd behaviors.
 • Drug diversion happens everywhere, even in regions with low opioid use.
• Not only workers with access to drugs can/will divert them. 

7. Know and keep track of areas throughout your organization that are the most vulnerable
Anywhere from the loading dock to the incinerator can be the point of failure. Whenever a new diversion method is revealed or reported, update your policies to reflect them.

8. Tell the police when it happens
When an employee is caught stealing or diverting drugs, you’re required by federal law to report him or her to the DEA. Also alert any applicable state professional licensing board or hospital licensing agency, and if the diverter is a physician or dentist, to the National Practitioner Data Bank.

9. Remember that thefts can occur at the bedside
As healthcare systems get better at preventing drug diversion at pharmacies and storage locations, then thefts will occur closer and closer to patient care, at the bedside.

10. Offer treatment once an employee is caught and terminated
After someone is fired for drug diversion, offer to help them seek treatment for their addiction.

Read the full article at HealthLeaders Media.

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