Overview

The number of unexplained losses of controlled substances from Canadian hospitals has increased annually since 2010 1,2


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Daily access to controlled substances and a stressful work environment are significant risk factors for developing a substance abuse disorder, and have significantly contributed to job-related mortality for some health care professions (anesthesiology, nursing) 3, 4, 5


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Diversion (theft) of controlled substances poses significant risks to patient safety. Consequences to patients include receiving less than the full dose of medication, caregivers working in an impaired state, and infection outbreaks from contaminated needles 6


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Best practices

BD advocates for the adoption of best practices to prevent, detect and manage diversion

The Institute for Safe Medication Practices (ISMP) supports the use of Automatic Dispensing Cabinet (ADC) systems that use biometric ID to enable secured access7.

The Canadian Society for Hospital Pharmacists recommends that inventory management processes be part of a linked system that allows controlled substances to be easily tracked as they move through the facility, and advocates for the continuous review of measurable and objective key performance indicators to prevent and detect diversion8.

BD Technologies

How BD Technologies can help improve security

BD’s technologies provide secured access to controlled substances through automated technology, enabling traceability and visibility to opioid dispensing and distribution across the medication-use process.9,10

BD improves diversion management capabilities within a facility by analyzing dispensing and administration activities and providing trend analysis and benchmarking metrics. 10

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References
  1. https://www.macleans.ca/society/health/unexplained-losses-of-opioids-on-the-rise-in-canadian-hospitals/
  2. Fan 2018. Identifying vulnerabilities in hospital medication processes that facilitate diversion in Canada. Canadian Society of Hospital Pharmacy Professional Practice Conference – February 6 2018.
  3. Trinkoff AM, Zhou Q, Storr CL, Soeken KL. Workplace access, negative prescriptions, job strain, and substance use in registered nurses. Nursing Research. 2000 Mar 1; 49(2):83-90.
  4. Warner DO, Berge K, Sun H, Harman A, Hanson A, Schroeder DR. Risk and Outcomes of Substance Use Disorder among Anesthesiology Residents: A Matched Cohort Analysis. The Journal of the American Society of Anesthesiologists. 2015 Oct 1; 123(4):929-36.
  5. Pilgrim JL, Dorward R, Drummer OH. Drug‐caused deaths in Australian medical practitioners and health‐care professionals. Addiction. 2016 Jan 1.
  6. Injection Safety [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2017 [cited 2017 Jun2]. Available from: https://www.cdc.gov/injectionsafety/drugdiversion/
  7. Guidelines for the Safe Use of Automated Dispensing Cabinets [Internet]. Institute For Safe Medication Practices. 2019 [cited 4 March 2019]. Available from: https://www.ismp.org/resources/guidelines-safe-use-automated-dispensing-cabinets
  8. Canadian Society for Hospital Pharmacists. Controlled Drugs and Substances in Hospitals and Healthcare Facilities: Guidelines on Secure Management and Diversion Prevention. March 2019.
  9. Anyanwu C, Egwim O. The prevalence and determinants of controlled substance discrepancies in a Level I trauma hospital. American health & drug benefits. 2016 May;9(3):128.
  10. Epstein RH, Gratch DM, McNulty S, Grunwald Z. Validation of a system to detect scheduled drug diversion by anesthesia care providers. Anesthesia & Analgesia. 2011 Jul 1;113(1):160-4.