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Learn MoreMost reports on the opioid crisis in America focus on individuals who receive a prescription for an opioid pain killer and then become a victim of opioid dependence. But what about the issue of dependence that occurs within the walls of the hospital? While 8% of the general population suffers with drug dependency, almost twice that number (15%) of healthcare workers are dependent on drugs and alcohol. This may be due to job stress and easy access to controlled substances. It is not unusual for drug dependent healthcare providers to risk patient safety by engaging in unethical and illegal medication tampering and misuse.
Drug Diversion Reveals Opiod Addiction a Problem for Healthcare Staff
“Many healthcare workers develop and feed their addictions through drug diversion—the transfer of any legally prescribed, controlled substance from the individual for whom it was prescribed to another person for any illicit use—which threatens patient safety. Often, when healthcare providers are diverting drugs, such as pain medications, they are stealing a prescribed medication for a patient and replacing it with some type of placebo, leaving the patient in pain” (Montgomery, 2017).
Furthermore, there are cases involving diverters using syringes on themselves first and then on patients, with the possibility of spreading diseases. One diverter is currently serving a 39-year prison sentence for infecting 45 patients through this deadly practice. The implications are not only related to patient safety—financial implications are also possible. A prominent academic medical facility was recently fined over 2 million dollars for poor practices that allowed drug diversion to occur (Montgomery, 2017).
Montgomery indicates that health IT can help. For example, automated dispensing cabinets (ADCs) can detect diversions in real time. Also, smart cabinets are able to detect pill miscounts or tampering with medicine cabinets and can connect this to an employee’s identification number. These actions along with monitoring each and every drug transaction via analytics are effective measures to counter drug diverters. Some facilities are going as far as hiring a drug diversion compliance officer to monitor drug flow across the hospital. (Montgomery, 2017)
Denial is a common response by many hospitals—some are unwilling to believe that drug diversion would occur in their organizations.
“Leading drug diversion experts believe that if a health system has controlled substances, a 100 percent chance exists for drug diversion. For successful control of the opioid crisis, widespread use and national adoption of health IT and other diversion prevention practices offer solutions (Montgomery, 2017).”
Everyone that works with controlled drugs in a healthcare environment must be empowered to be vigilant, to question suspicious activities, and to act. This kind of vigilance and response may be difficult in an environment of intimidation. Thus, leadership must be supportive of staff that come forward and encouraged to bring up potential issues. “Typically we think of the staff that is most proximate to controlled drugs as having the greatest opportunity to notice when someone or something does not seem right. With drug diversion, all levels of staff should be encouraged to speak up including environmental service, food service, and maintenance. Empty drug vials in the wrong place or tampered waste containers may be evidence of diversion activities and should be brought to the attention of the department leadership. It is important for senior leadership to close the loop with staff who speak up to let them know the importance of their contributions to patient safety (Jorgenson, 2016).”
Teamwork is vital in ensuring safety in the lives of patients and staff and in identifying and dealing with drug diversion. An effective, comprehensive diversion program relies upon the functioning of a multidisciplinary team for guidance and oversight. “Since diversion is an organizational problem, the committee should have members from pharmacy, nursing, anaesthesia, security, accreditation, human resources, risk management, lab, environmental services, and human resources, as well as representatives from the medical staff and senior leadership. The team would be responsible for policies, procedures, staff education and training, diversion monitoring, and management of diversion events. Ideally the team would be aligned with other patient safety efforts and report through similar channels to the Board (Jorgenson, 2016).”
A third solution to the issue of drug diversion relates to the pharmacy. “It is extremely important that pharmacies be prepared to meet this challenge by focusing closer attention on prescriptions dispensed, ensuring that hiring policies and accountability policies and procedures are sufficient to detect, discover, and respond to the recent opioid drug crisis, as well as identify impaired health care workers and assist them in seeking appropriate programs for recovery (Montgomery, 2017).”
This blog post excerpts an article in our complimentary eBook about Threats to Healthcare, Workforce Readiness: Preparing Today for Tomorrow’s Unknown. Download it here.
References
Jorgenson, J. (2016). Drug diversion in hospitals: Are you next? Beckers Hopital Review. Retrieved from https://www.beckershospitalreview.com/hospital-management-administration/drug-diversion-in-hospitals-are-you-next.html
Montgomery, H. (2017). The opioid crisis in hospitals-what you may not know. HIMSS. Retrieved from http://www.himss.org/news/opioid-crisis-hospitals-what-you-may-not-know
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's Provider Credentialing, privileging, & enrollment solutions.
View All CredentialingExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products