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Healing is Coming - February 2021 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1. About _____ of nurses will suffer from substance use disor- der during their careers, accord- ing to the American Nurses Association. a. 5% b. 10% c. 15% d. 20% Answer: b Keep an eye out for the warning signs of addiction, suggests Zachary Bouchat-Friedman, PharmD, a staff pharmacist at Allegheny Valley Hospital in Natrona Heights, Pa. Warning signs include employees who are fre- quently late, calling out sick, disap- pearing for extended periods of time while on the clock. Other red flags include pin- point pupils, an unkempt appearance and a history of disciplinary actions or mistakes. "These employ- ees will often blame the environment or others for their mistakes, and will claim to experience frequent personal emergencies," says Dr. Bouchat-Friedman. Also be suspicious of providers whose patients report little to no pain relief. "A nurse could easily scan a medication and the patient's ID — thereby completing the administration documentation — and simply omit the controlled substance dose or administer a 'dummy' injection in its place," says Dr. Bouchat-Friedman. 2. Which of the following is the most commonly diverted medication, according to the Drug Enforcement Administration? a. hydromorphone b. oxycodone c. fentanyl d. morphine Answer: c Theft of a controlled substance is a felony, but the guilty party can simply move to another state and easily attain another job (depending on how thorough the new employer is in conducting a back- ground check), according to Dr. Bouchat-Friedman. Keep in mind that some providers who suffer from substance use disorder might not display any warn- ing signs — they're smart and careful, and go to great lengths to avoid being caught. That's why it's essential to closely monitor the dispensing and waste of all controlled substances, and keep them secure until they're needed. He says medication safeguards should be strict and effective. "All controlled substances must be stored separately in a secure location," he explains. "Document every dispense and return, and require a blind count by a staff member. Most of the con- trolled substances in our hospital are delivered to automated storage cabinets, which electronically log dispenses, returns and waste by providers." Disposal of leftover doses (a partial tablet or an unemptied vial) requires a second individual's (wit- ness) signature. The wasted portion should be placed into a controlled substance waste manage- ment system, which automatically secures pharma- ceuticals and renders them unusable. These systems should be within easy access of where medications are administered to allow for the proper disposal of solid and liquid controlled substances. Additionally, F E B R U A R Y 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 4 7 METICULOUS MONITORING Don't let your facility's medication storage and disposal protocols fall through the cracks.

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