Drug Diversion. New Jersey s Drug Diversion Pilot Project Exercise

Transcription

1 Drug Diversion New Jersey s Drug Diversion Pilot Project Exercise

2 What is Drug Diversion? When prescription medicines are obtained or used illegally Illegal distribution or abuse of prescription drugs or their use for unintended purposes

3 Why is a public health response necessary? 1. Recommend patient notification and testing 2. Determine risk of disease transmission 3. Implement control measures 4. Identify individuals at risk 5. All of the above

4 Drug Diversion in Healthcare Settings When healthcare providers steal controlled substances for their own use, it can result in: Substandard care delivered by an impaired healthcare provider Denial of essential pain medication or therapy Risk of infection if a provider tampers with injectable drugs Tampering/Substitution are common types of diversion in healthcare settings

5 Source: Centers for Disease Control & Prevention, cdc.gov and oneandonlycampaign.org

6 Source: Centers for Disease Control & Prevention, cdc.gov and oneandonlycampaign.org

7 NJ s Injection Safety Initiative One of seven funded injection safety partners Drug Diversion is a component of the federal initiative Hosted first Drug Diversion conference in June 2015 >100 public health, healthcare and law enforcement/security professionals attended NJ Drug Diversion Coalition formed in September 2015 Volunteer group meets bi-monthly to discuss issues Risk managers, Dirs. of Nursing and Pharmacy

8 NJ s Drug Diversion Exercise Pilot project with four acute care hospitals Players included: Administration, Nursing, Pharmacy, Infection Control, Risk Management, Security and more Exercise features three scenarios with injectable drug diversion Exercise objectives: Discuss policies related to drug diversion Highlight strengths of existing policies Identify gaps in existing policies Identify ways to train/communicate with staff about policies Explore process of responding to drug diversion incident (internally and externally)

9 NJ s Drug Diversion Exercise - Results Policies vary from facility to facility Good relationship between pharmacy and nursing supervisors RE: controlled substances reports NJ DOH(Health Facility Survey & Field Operations) not always contacted after drug diversion All facilities contacted professional boards, but NOT NJDOH Law enforcement involvement varies After a drug diversion incident of injectable medication, no thought about disease transmission Identify a point person to work with public health in the event of potential exposure to bloodborne pathogens Role of IP in drug diversion incidents varies

10 Example of a Drug Diversion and the Role of Public Health Hospital employee charged with drug diversion tampering/substitution and theft of controlled substances (injectable medications) Hospital reaches out to state and local health departments to determine next steps Public health assesses risk for bloodborne pathogen (BBP)/consults CDRSS to determine employee s BBP status Public health defines potential exposed patients through epidemiology investigation; patient notification possible

11 Example of a Drug Diversion and the Role of Public Health Patient notification letter Public health provides assistance to hospital and local health department to craft notification letter Testing for bloodborne pathogens recommended Letter clarifies who gets tested and why Local health department and NJDOH assist with communications ( Talking Points ) Bloodborne pathogen fact sheet available in English and Spanish on NJDOH website Is a hotline/call center set-up to triage calls Who signs pt. notification letters Letters should be sent certified mail ( Duty to Warn ) Communication among partners is critical

12 Example of a Drug Diversion and the Role of Public Health Testing logistics are determined NJDOH provides testing codes and laboratory specimen instructions Who signs the standing orders (hospital, local or state)? Is follow-up testing needed? How early is exposure detected? Reimbursement if patients use personal physicians instead of clinic? Where will testing take place? Alternate testing for out-of-state/area patients? Local health department and NJDOH follow-up epidemiology with positive patients

13 Example of a Drug Diversion and the Role of Public Health NJDOH develops/updates/distributes talking points Used at call center Provided to all partners Call center opened Who operates/staffs? Hours of call center set by sponsoring agency Just-in-Time training for call center staff Call center/partners notify NJDOH of questions to add to talking points LHD follows-up with positive cases

14 Thank you! For more information or questions, please contact -- Laura Taylor, PhD, MCHES

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16 Upcoming Conferences Communicable Disease Investigator Training July 13, 2016, 9am to 4pm Capital Health-Hamilton, 1445 White Horse- Mercerville Rd Public health and nursing credits Free! Lunch on your own Registration coming soon:

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19 Final Notes Return clickers Sign-out Nurses: pick-up certificates Check and complete evaluation Slides are posted on NJLMN under Practice Exchange