Drug diversion a chronic problem for hospitals
Drug diversion is a longstanding problem for hospitals and can take many forms, says Leilani Kicklighter, RN, ARM, MBA, CPHRM, LHRM, a patient safety and risk management consultant with The Kicklighter Group in Tamarac, FL, and a past president of the American Society for Healthcare Risk Management (ASHRM) in Chicago.
Safeguarding the hospital’s own drugs isn’t enough. Often patients come in with their own controlled substance medications prescribed by their physician, which can be stolen by a staff member, contracted or employed, she notes.
In addition to all the other concerns with drug diversion, a compliance issue can arise if the hospital charges for medications that weren’t provided.
"I once had an issue when the husband and wife were sharing an access card to the drug dispensing machine, giving patients saline and diverting the drugs," Kicklighter recalls. "We had to review all records over previous six months and back out charges for any controlled substance ordered since we were not sure who got the actual drug and who didn’t. This fell under guidance of the compliance officer in conjunction with risk management."
Kicklighter recalls another situation in a surgery center where a nurse with chronic pain stole blank prescriptions pads from where they were locked in the medication room. That central lockup was the first fault, she says, because anyone authorized to prescribe controlled drugs should be responsible for their own prescription pads by keeping them locked up and under their own care, control, and custody.
"Random drug screens is one way to deal with this issue, but that is fraught with all sorts of issues if not implemented and applied appropriately and randomly applied and may not identify those who are diverting, not to mention the additional cost."
