In this Diversion Insights Quick Take, I examine an intriguing comment I heard recently while discussing missing medications with a client. New nurse hires from across the country consistently express surprise at how seriously this facility takes controlled substance management compared to their previous workplaces. Join me for this 5-minute discussion about what this reveals about the inconsistency in hospital protocols nationwide and why robust controlled substance oversight should be the standard, not the exception.
Transcript
Hello, listeners. Thank you for tuning in. I wanted to share something that came up recently that I found actually kind of fascinating. I think it’s always good. We oftentimes maybe think we know the answers and it’s so obvious. And then we talk to other people and we get other perspectives, and it can be very enlightening. I recently had a nurse manager share that when they are onboarding new nurses, not just new grads, but new nurses from all around the country coming from someplace else to their facility. What they hear a lot, actually, is, wow, you guys really have strong rules or accountability around controlled substances. You really take it seriously. Way more seriously than other places that I’ve worked, which I actually find quite astonishing. Now, this is a facility that I’ve worked with for quite some time. They have a wonderful diversion program.
I’ve seen it grow over the years, and it has really blossomed into a very robust program. But when you get right down to it, yeah. They have policies that talk about, you know, how long a nurse has to administer waste or return a medication after removing it from the automated dispensing machine. They do have diversion software, so they have insight into everything. And they do a good job of following up for every missing dose. And by that I mean somebody dispensed it, but then where did it go? Either in full or partial. Right. Maybe it was a partial administration, but there’s no documentation of waste. Or maybe in a recovery procedural area where maybe there was another one given. You don’t know whether it was administered because it wasn’t charted or it could have been wasted.
So they have those in play and they have automated dispensing machines. So to me, that’s kind of the basics that every facility should have in play and then hold people accountable. But were talking about, you know, even still there are missing doses, so where. Where are they going? And you get all kinds of answers, like, oh, I meant to do it in the adm, but I didn’t do it, or I didn’t know it was controlled substance, or, oh, I was busy, or I couldn’t find a witness or whatever the reasons are. And so they add up. You know, they’re onesies, twosies. These are things outside of probably diversion, not diversion, more like practice. And just we’re not accountable for that controlled substance.
But what I just found interesting as were discussing it and how we could improve those metrics was the feedback from that nurse manager that nationwide nurses that they have come work at this facility. She has heard it more th
