Helping pharmacy leaders in the fight against drug diversion

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As the opioid epidemic continues and pharmacy teams have less time to investigate drug diversion amid the COVID-19 pandemic, hospitals become bigger targets for diversion of controlled substances.

During an April 28 webinar sponsored by LogicStream Health and hosted by Becker's Hospital Review, industry leaders discussed identifying drug diversion within hospitals and how a proactive approach to investigating incidents can facilitate compliance and reduce risk.

Panellists included:

  • Julia Schimmelpfennig, PharmD, pharmacy director at St. Elizabeth's Hospital in O'Fallon, Ill.
  • Andy Schuelke, PharmD, regional informatics pharmacist at St. Vincent Healthcare in Billings, Mont.
  • Janice Ahlstrom, RN, director of risk advisory at Baker Tilly
  • Patrick Yoder, PharmD, co-founder and CEO of LogicStream Health

Four takeaways:

1. Risks. Drug diversion is widespread in the U.S., and the ramifications for patients can be significant, including inadequate pain relief and exposure to infectious diseases from contaminated needles and drugs, according to Ms. Ahlstrom. Over a 20-year period of research, the CDC investigated "just nine drug diversion incidents," which found that "163 patients were impacted by either a gram-negative bacteria or hepatitis C infections in their systems," Ms. Ahlstrom said.

2. Identifying diversion. One of the biggest challenges hospitals face in identifying drug diversion is the time commitment from staff, especially in the past year as the COVID-19 pandemic placed more burdens on pharmacy leaders, among other providers, Dr. Schimmelpfennig said. "A lot of things have changed over the past year, and the time that we would have liked to invest in looking at diversion has decreased. The team just doesn't have as much time with this anymore."

3. Evolving responsibilities. Technology such as EHRs and automated dispensing units have driven nurse managers and charge nurses to take responsibility for discrepancies appearing in their units. Investigations should take place throughout the entire life cycle of controlled substances — from procurement to the receipt, prescribing, administration, waste and removal of medications. "You can find opportunities for diversion and the need for investigation along that entire life cycle," Ms. Ahlstrom said. Nurse managers and charge nurses are now having to address and resolve these issues in a timely manner to help hospitals and health systems with follow through, she added.

4. A proactive stance. Using software automation to review 100% of medication transactions and uncommon administration, dispense, waste, and return procedures outside the norm are effective ways that pharmacy leaders can identify potential drug diversion activity. As opposed to responding to a nurse commenting that her coworker is acting strange, pharmacy leaders can use software to identify if a nurse is using "a lot more standard deviations above other nurses in the same unit taking care of the same patients," Dr. Schuelke said.

Click here to learn more about LogicStream Health and here to view the full webinar.

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