1. Drug Diversion in Healthcare
Prevention and Detection

2. Scope of the Problem
Reliable statistics regarding the prevalence of drug diversion by healthcare workers are not available
Diversion can happen anywhere and is a universal problem
Many cases go undiscovered or unreported

3. Who and Why?
Two factors impacting the incidence of drug diversion by healthcare providers are ACCESS and AVAILABILITY
Generally, healthcare workers divert for personal use and are extremely secretive about it.
Other reasons may include diversion for profit (to sell), or diversion for family (to use).
Bell DM, McDonough JP, Ellison JS, Fitzhugh ED. Controlled drug misuse by Certified Registered Nurse Anesthetists. AANA J
1999;67(2):

4. Does Diversion Affect Patients & Residents?
YES!
Impairment/Addiction puts patients at risk
Patients may be denied appropriate pain relief
Patients may be billed fraudulently
Patients may be exposed to blood borne pathogens

5. Rockcastle Regional Drug Diversion Prevention
Rockcastle Regional has a drug diversion prevention program in place
Drug screening of employees may take place pre-employment, at random, for cause, and after a work related accident or injury
Missing and/or tampered with medications are investigated immediately
Controlled substance documentation is audited randomly and frequently
Reporting is MANDATORY- immediately

6. When to Report: Signs of Impairment
Severe mood swings, personality changes
Elaborate excuses
Underperformance; poorly explained errors, accidents, or injuries
Frequent or unexplained tardiness, work absences, illness, or physical complaints
Confusion, memory loss, difficulty concentrating, unreliability
Relationship discord (family or professional)

7. When to Report: Signs of Diversion
Consistently uses more drugs than colleagues
Frequently volunteers to administer controlled substances or relieve colleagues of casework
Consistently arrives early, stays late, or volunteers to work overtime
Frequently takes breaks or trips to the bathroom
Frequently wastes large amounts
Carries drugs or syringes in pockets

8. Where to Report
If you suspect a healthcare worker of diversion or impairment, your responsibility is to report it immediately.
Report to any of the following:
Supervisor
Director of Nursing
Risk management
Pharmacist