Guest Author: Kimberly New, JD BSN RN
President, Tennessee Chapter of the National Association of Drug Diversion Investigators
You may have seen some recent media reports about drug diversion. Today, I want to break down the issue of drug diversion and provide some details about this serious patient safety threat.
Drug diversion, or theft of drugs, by healthcare personnel poses a continuous threat to patient safety in any healthcare setting in which controlled substances are handled. Although personnel who divert originally went into healthcare to care for patients, they have made poor choices for which they are accountable, including the impact their actions have on others. The longer a healthcare worker is allowed to steal medication, the greater the consequences become. Impaired providers can harm patients by providing sub-standard care, denying medications to patients, or exposing patients to tainted substances.
Tampering is the worst type of diversion. Commonly, the diverter removes medication from a syringe, vial, or other container and injects him- or herself with the medication. The diverter then replaces the stolen medication with saline or sterile water, or another clear medication or liquid. The “replacement liquid” is later used on the patient by an unaware provider. When tampering, the diverter may rarely use sterile technique. Ultimately the patient doesn’t receive the required medication and may be exposed to the diverter’s blood.
It’s as if the patient and the diverter are sharing needles. Any bloodborne infections, such as hepatitis C, that the diverter has been infected with can be passed on to the patient, even though they may be asymptomatic.
Even individuals who are not patients may be placed at risk as a result of diversion by a healthcare worker. For example, they may be harmed by a worker who is driving in an impaired state. It is not uncommon for workers to self-administer diverted narcotics while leaving their workplace. In one case, a diverter left her shift, drove home in an impaired state, and caused a head-on collision when she went the wrong way on an Atlanta highway.
Diversion is a scary, often unspoken threat to patient safety. Lately, there has been a trend towards transparency to highlight this problem. In my next blog, I am going to discuss how diversion negatively impacts hospitals and other healthcare facilities.
In the meantime, let me know your thoughts.