Hospital Drug Diversion: Understanding Global Perspectives

Subject: Administration and Regulation
Pages: 8
Words: 2293
Reading time:
8 min

Over the years, there has been a gradual rise in cases of medical practitioners diverting narcotics in various hospitals. This trend will undoubtedly harm patients if no measures are taken to resolve the issue. Through the BSN Program, I have learnt that diversion of narcotic is the current narcotic diversion percentages in Grace Hospital, which is a preventative felonious act. The issue is rapidly becoming a grave problem. In 2012 alone, Grace Hospital, recorded ten cases of prescription narcotics diversion. Therefore, I intend to identify measures that the hospital is applying to tackle the issue and the adjustments it needs to make. The rise of drug diversion is exacerbated by the fact that medical practitioners have unlimited liberty to access the controlled drugs storage rooms. In order to combat drug diversion, I have learnt that the Hospital has adopted several preventative measures; for instance, recording every procedure in the custody sequence and electronic ordering techniques to ensure efficient documentation. Furthermore, there is periodic alternation of staff to avoid a scenario whereby a particular individual is solely responsible for ordering and receiving prescribed narcotics. The prescribed drugs are also stored in a central position and a single staff member assumes the duty of keeping the keys. The hospital should personalise every unit floor’s supply by distributing only the required amount of drugs in unit-dose boxes. Furthermore, automated supply cabinets that comprise reports that involuntarily settle transactions to disclose discrepancies quickly should be introduced. Another effective drill to reduce drug diversion in Grace Hospital should be to install pyxis machine and narcotic count that will help in monitoring the movement of controlled substances within the hospital (Vrabel, 2010).

Providing Culturally Sensitive Population Based Care

I have learnt that nurses and pharmacists play a central role in preventing diversion of controlled drugs. They assemble prescription account data on all the schedules of the narcotics. Moreover, nurses and pharmacists also gather data to detect individuals who are under medication, which helps in averting the problem of providing drugs to people not under prescriptions. Hence, I intend to gain further knowledge concerning pharmacy and nurse managers’ role in averting narcotic diversion. Studies disclose that in Massachusetts, 38 per cent of people who come to pick drugs often have no prescription letter from a recognized medical practitioner and the absence of a proper mechanism to detect such individuals generates an opportunity for diversion (Fischer et al., 2010). Hence, it is essential for nurses to call on patients to produce customer IDs whenever they come to pick their medication in a bid to avert prescription deceit. Considering that most nurses are oblivious of above fact, I aspire to identify ways to educate personnel on how to identify, supervise, and combat drug diversion. Nurses and pharmacy managers should know that medical practitioners who prefer cash payments frequently try to evade detection by the payment systems. Pharmacy managers should also minimise the interval for collecting information; for instance, reducing it from monthly to a daily basis (Ford & Lacerenza, 2011). Nurses can consider some other basic tips to help them in detecting if a drug diversion has transpired. For instance, if the quantities supplied seem to be unusually huge or the amount of restocks show signs of adjustments, then one can conclude that a diversion has occurred. Additionally, to espouse secure delivery and usage of prescription drugs, medical practitioners should introduce serialised prescription forms as well as link records to authorise recognition of individuals (Vrabel, 2010). Apart from these security measures, I intend to apply more techniques that can be used to manage the transfer and dispense of controlled drugs.

Compassionate and Appropriate direct and indirect nursing care in managing illness and diseases

Through the BSN Program, I have acquired ample knowledge in relation to essential components of clinical site-based learning, which embraces care along a scale theory. This scale of care embraces health promotion, threat diminution, disease deterrence, and treatment of ailments. Moreover, it also underscores that nurses should work closely with interdisciplinary and intradisciplinary teams in the health profession to ensure that fellow staff members do not participate in behaviours that are contrary to the ethics and policies of a hospital (McKinney, 2012). Nurses should adopt harmonisation, teamwork, and communication aspects when performing various tasks with individuals from other fields in the health care systems that are responsible for interdisciplinary to enhance the health status of patients. According to the various weekly interdisciplinary meetings that I have been having over the past months, I have learnt certain factors and procedures to consider when determining if a person is guilty of a narcotic diversion. First, the hospital must identify individuals who form the interdisciplinary team, which should incorporate staff from the security, human resource, pharmacy, and employee health department. Secondly, the hospital should define the duties of every member of the disciplinary group. Thereafter, it should establish a monitoring technique, which should comprise automated techniques that assist in discovering potential diversions (McKinney, 2012).

Effective communication, collaboration and negotiation

I intend to seek the guidance of preceptors, nurses, and pharmacy managers in the preparation and implementation of the drug diversion project. In the past meetings that have been having with interdisciplinary teams, I have learnt that soon after forming the disciplinary team and determining the monitoring technique, they can then proceed to the next stage of conducting a narcotic diversion interview, which must oblige to certain factors. First, the interview must have a standardisation process to solve issues such as who presides over the interview, the location, and timing of the interview (Vrabel, 2010). Secondly, the interviewers should use a behavioural evaluation procedure that can help in evaluating the credibility of a suspected nurse’s response. This behavioural procedure falls into two phases. In the first phase, the suspected individual undergoes a succession of questions to analyse his or her honesty. If the interviewers identify deceptive reaction from the suspect, then they should proceed to the next phase. In the second stage, the questions are more aggressive (McKinney, 2012). The aim of this phase is to eliminate the obstacle of insincerity amongst medical practitioners. Presumably, after undergoing the confrontational questions, the culprit is likely to give a verbal confession (Ford & Lacerenza, 2011).

Professional Code of Ethics and Legal Statutes

The American Nursing Association (ANA) code of ethics comprises nine provisions that clearly define the manner in which nurses can dispense their skills professionally. The BSN Program has taught me to utilize this code of ethics in activities connected to my nursing profession. The first provision requires nurses to deliver their services with compassion and reverence for the intrinsic dignity of every person without discriminating one’s socioeconomic status or characteristics of his/her health problems among other factors. The respect demanded from the nurses is not only limited to the patients, but also fellow workmates and community as a whole (Vrabel, 2010). Moreover, the third provision mandates nurses to make an effort to defend the health, rights, as well as security of clients (McKinney, 2012). The fifth provision stipulates that nurses should maintain integrity and accountability to ensure professional growth in their working environment. With reference to these provisions, every nurse should condemn any activity that may appear unethical and map out ideas that can help in combating such activities. Drug diversion is an unethical activity because it contravenes almost all the provision of ANA code of ethics. Therefore, it is crucial for hospitals to adopt principles to encourage healthy lifestyles through health promotion, threat diminution, and prevention of disease (Fischer et al., 2010). Among the best practice principles, which the Grace Hospital can apply to avoid drug diversion, include enhancing storage and security system, improving the procurement, prescribing, and the supply process. Moreover, the hospital should establish a random observation and drug screen procedures as a way of following up drug diversion cases (Ford & Lacerenza, 2011).

Applying Principles of Teaching and Learning to Promote Healthy Lifestyles

In the process of learning BSN Program, I discovered the most pertinent prevention roadmap should incorporate a technique that can be abbreviated as S.A.F.E. The “S” stands for a safety team structure, “A” refers to access to data, “F” stands for facility anticipations whilst “E” stands for education. The “safe team” calls for hospitals to create an interdisciplinary team with an organisation composition. Moreover, the established interdisciplinary team must create a link with the law enforcement and reporting institutions so that culprits of drug diversion can be handed over to the government to be punished for their misdemeanours (McKinney, 2012). On the other hand, “access to data” involves analysis of information and audits. Moreover, it encourages relevant authorities to investigate and quantify the findings and eventually share the information with other members of the interdisciplinary team. Under “facility anticipations”, the hospital is mandated to communicate its anticipations to the personnel by fully revealing its policies. The policies should also correlate with the guidelines of the human resource management. Furthermore, hospitals should educate their pharmacists to stop sharing pass codes to prevent unauthorised staff members from accessing drug stores. “Education” is also among the means that should be utilised in preventing drug diversion. The education program should include all the personnel coupled with emphasising on informing the workers on the necessity of eliminating drug diversion (McKinney, 2012).

Best Practice on current Knowledge and Theory

As the hospital employs the principles and ideas to eradicate drug diversion, they should conduct a culture assessment to check if the stakeholders are ready to adopt new policies. The hospital authorities should analyse the culture of patients, health structures, and the personnel. In developing drug diversion rules and regulations, the hospital must adhere to certain guidelines. First, the policy must mention the internal and external reporting duties. Secondly, the policy must also consider the temperament of workers. Once the policies have been developed, the hospital should then create a monitoring method that can help in revealing potential diversions in the health centre (Fischer et al., 2010). These methods include installing computerised systems that assist in determining potential diversions and applying modern technology in the storage systems. The medical practitioners should reduce intervals of counts and exceptions.

Providing Leadership within the Interdisciplinary Healthcare teams and Regulatory Organization

In the course of the BSN program, I have discovered that one of the most pertinent instruments that interdisciplinary and regulatory teams should use in eliminating drug diversion is the data extraction software. The software is suitable for evaluating the usage sequence from the computerised dosing cabinet coupled with discovering inconsistent usage up to 0.5 criterion digression from the expected mean. Furthermore, the software has the capability to detect potential digression activities (Vrabel, 2010). Data extraction software could be used to detect a single medication diversion. For instance, a patient whines of consistent pain and soon after, a nurse realises that the patient took hydrocodone an hour before the prescribed time. However, the patient denies that he had taken any controlled substances. This response alarms the nurse who has prescribed the drug and reports the case to the pharmacy management. The pharmacist in charge reacts by using data evaluation software to check for potential diversion through computerised dosing cabinets being overseen by the reporting nurse. The software eventually reveals that the accused nurse had unusually lofty supply if hydrocodone in relations to other nurses (Ford & Lacerenza, 2011).

Using Managing Skills to apportion and manage resources and evaluate nursing outcomes

The BSN Program has helped me to discover some managerial skills that can be used to avert drug diversion. It is important to formulate policies that would help in managing drug abuse both within and outside the hospital boundaries. The hospital should formulate policies that can analyse the aberrant drug taking behaviour of patients or nurses (Vrabel, 2010). Nurses and patients who are drug addicts to abusing drugs may apply even drastic measures such as buying drugs from the streets or diverting drugs from loved ones or friends who are under legitimate medication in effort to access drugs (McKinney, 2012). The impact of this move may be detrimental not only on the health of the patient whose drugs have been diverted, but also to the drug abusers. Hence, linking such culprits to the law enforcers is not the ultimate solution to the problem. I aspire to create an educational pamphlet for Grace Hospital staff explaining drug diversion and its detrimental impacts on patient care and nursing performance. Moreover, I propose that a risk of abuse assessment program should be introduced in the hospital to help nurses in identifying colleagues that are victims of drug abuse and diversion in the health institution. During the assessment, the relevant authorities should check the history of the victims in relation to abusing tobacco and other lethal drugs, the victims’ family backgrounds, and surrounding (Fischer, et al., 2010).

Responsibility for Lifelong Learning and Professional Career Development

Drug diversion is still a recurrent problem not only in Grace Hospital, but also across the U.S. and the entire globe in general. Hence, it is important to adhere to the above approaches in an attempt to minimise or eradicate drug diversion in Grace Hospital. Mutual application of computerisation, manual inspections, and an interdisciplinary team technique will minimise the threats and cases of prescribed narcotic diversion. Establishing several levels of reporting will help in identifying incidences of drug diversion (Fischer et al., 2010). Espousing and educating staff on the dangers of drug diversion will enhance unity and greater participation from nurses on how to develop quality, minimise system failures, and avoid inaccuracy. In an attempt to obtain current information and more knowledge concerning drug diversion, I am planning to participate in compulsory annual compliance and trainings and research MSN programs that can positively help me in getting ideas on how drug diversion can be avoided.


Fischer, B., Bibby, M., & Bouchard, M. (2010). The Global Diversion of Pharmaceutical Drugs Non-medical use and diversion of psychotropic prescription drugs in North America: A review of sourcing routes and control measures. Addiction, 105(12), 2062-70.

Ford, A., & Lacerenza, C. (2011). The relationship between source of diversion and prescription drug misuse, abuse, and dependence. Substance Use & Misuse, 46(6), 819-827.

McKinney, M. (2012). Diverting trouble. Modern Healthcare, 42(50), 26-28.

Vrabel, R. (2010). Identifying and dealing with drug diversion. Health Management Technology, 31(12), 1-5.