unlocked drawers or on anesthesia machines and cover them with a
blue towel while they ready the patient or other supplies for surgery.
That leaves unsupervised staff members with relatively easy access to
controlled substances, so anesthesia providers need a secure space to
store prepared medications. Automated anesthesia workstations are
ideal, but non-automated cabinets with locking drawers are also effec-
tive solutions.
Don't trust your instincts
Opioids are usually diverted for personal use, although there has
been an increase in direct sales of stolen medications by healthcare
providers. Diverters steal throughout a shift, stockpile medications
and might self-administer the drugs in the bathroom or in their car.
Over time, their diverting ways might withhold medications from
patients in need and put patients at risk of being infected with blood-
borne pathogens.
The staff member who's doing the diverting is almost always a top
performer who's very well-liked and respected. In other words, the
last person you'd expect. That's why it's important to look for indica-
tions of diversion in drug transaction data instead of waiting to notice
behavioral red flags, which are a very late sign of trouble. By the time
you realize a staff member is diverting, it might be too late to help him
or prevent harm to patients.
Ensure waste is wasted
Visually witnessing the destruction process is required by regula-
tory and professional standards. Get rid of excess medication as soon
as possible after the case's conclusion. Wasting or returning medica-
tions should be a 2-person process — the person who's wasting the
excess medication and the witness who's watching them do it. Both
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