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Drug diversion in health care : a guide to identification and prevention

Author: Donald E Bogardus
Publisher: Marblehead, MA : Opus Communication, ©2002.
Edition/Format:   Print book : EnglishView all editions and formats
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Genre/Form: Case studies
Document Type: Book
All Authors / Contributors: Donald E Bogardus
ISBN: 9781578392209 1578392209
OCLC Number: 51565163
Description: xiii, 130 pages ; 27 cm
Contents: Narcotics Diversion --
Profile of a narcotics diverter --
Enabling coworkers --
For-cause mandatory urine testing --
Case History: Urine testing --
Diversion Through Substitution --
Methods of substitution --
Case History: Rebuilt unit-dose syringe trays --
Syringes switched at patients' bedsides --
Substitution in surgical areas --
Case History: Unit-dose syringes switched at patient's bedside --
Substitution at point of origin --
Substitution involving multi-dose vials --
Bulk diversion techniques --
Intravenous bags --
Tablets and capsules --
Ampules --
Case History: Substitution of Fentanyl in ampules and syringes --
Sterile water and sodium chloride bottles --
Diversion during disposal --
Fentanyl patches --
Substitution in a pharmacy --
Theft of Narcotics Through Charting Techniques --
Detecting diversion by charting techniques --
Keeping signed-out medications --
Signing out the last doses on the sign-out sheet --
Case History: False verbal physician orders --
Case History: Charting technique uncovered --
Forgery --
Backdating --
Case History: Forgery and backdating --
Falsifying physicians' orders --
Continuous inventory sign-out sheet design --
Column for dates --
Dosage-administered column --
Wastage column --
Color bars or lines --
Inventory transfers --
Destroying CISS and single sign-out sheets --
Other Common Diversion Techniques --
Large-quantity thefts of unit-dose syringes --
"Brown bag" theft --
Case History: Discarded unit-dose syringes --
Case History: Theft of entire narcotics order. Case History: Theft of sign-out sheet and narcotics --
Theft during shift change --
Case History: Theft during shift change --
Case History: Theft at end of shift --
Fentanyl patch theft --
Wastage of Fentanyl patches --
Case History: Fentanyl patch ingestion --
Pharmacy thefts --
Case History: Pharmacy theft --
Falsification of physician verbal orders --
Case History: Theft via physician verbal orders --
Theft from surgical areas --
Case History: Sufenta diversion --
Simple theft --
Case History: Opportunity for theft --
Automated Dispensing Systems --
Database management system --
Case History: Reports from automated dispensing system --
Forgery --
Time-sensitive automatic log-off feature --
Case History: Pyxis Consultant and the "proactive drug search" report --
Case History: Pyxis reports and other data management investigative tools --
Case History: Use of cancelled removals to obtain narcotics --
Case History: Improper use of coworkers user ID and password to document wastage --
Politics of Investigations and Treatment of Addicted Workers --
Use of outside law enforcement agencies --
Treatment of addicted health care workers --
Return to work issues --
Investigative Techniques --
How to investigate diversion of narcotics through substitution --
Investigation of unit-dose syringes switched at patients' bedsides --
Investigation of narcotics diversion through charting --
Investigation of diverting medication refused by patients --
Investigation of theft of "as needed" medications --
Investigation of forgery. Investigation of signing out the last units --
Investigation of backdating and forgery --
Investigation of alterations of physician orders --
Investigation of unauthorized use of user IDs and passwords --
Video Surveillance Techniques --
Surveillance equipment --
Surveillance cameras --
Color vs. black-and-white cameras --
Video recorders --
Video monitors --
Surveillance techniques --
How to conceal a surveillance camera --
Wireless cameras and recording devices --
Case History: Pinhole lens --
Installing a camera in an automated dispensing unit --
Case History: Installing a camera in the Pyxis unit --
Narcotics Testing --
Developing a list of refractive index readings --
Refractive index test --
preliminary only --
Reverse testing --
Case History: Refractometer use --
Confrontation and Interview --
Confronting a suspect --
Interviewing the suspect --
Help the employee return home safely --
Evidence --
Collection of stolen narcotics --
Charts and other medical documents --
Verbal confessions --
Written confessions --
Obtaining a urine sample --
Treatment and Storage Regulations.
Responsibility: Donald E. Bogardus.

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