individuals should document and sign the drug and drug amount that
was wasted and the time the wasting occurred.
Don't forget to expel all traces of medications from vials, syringes
or IV tubing before discarding them because diverters in the throes
of addiction will go to great lengths — including trying to save trace
amounts of drugs from thrown-away supplies — to get a quick fix.
To eliminate that possibility, consider adding controlled substance
waste receptacles to your ORs. The devices deactivate or bind con-
trolled medications to render them unusable. Models specifically
designed for the surgical setting are available.
Go see for yourself
Get out from behind your desk to watch how medications are
being handled in actual practice. Pop into ORs to see if drugs are
being kept secure or if they're left unattended and can be easily
diverted. How are controlled drugs delivered to patient care areas?
How soon are drugs prepared in relation to administration? Where is
the wasting of excess medication occurring? You won't know for cer-
tain unless you perform unannounced rounds. Frontline staff see and
know the security loopholes that are impossible for you to notice. Ask
them about the challenges they face in keeping drugs secure and how
they would divert medications if given the chance. You might be sur-
prised by what you find out, but their insiders' insights will prove
invaluable.
OSM
Ms. New (kimberly@diversionspecialists.com) is the founder of Diversion
Specialist, a medication security consulting firm based in Nashville, Tenn.
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