It only took 3 nurses and 3 surgical techs to infect more than 100 patients and put 30,000 more at risk of exposure to bloodborne or bacterial pathogens. Their outbreaks, sparked across 8 states over the past decade, were the result of on-the-job drug diversion and should serve as a patient safety warning, say epidemiologists from the Centers for Disease Control and Prevention.
In an article published in the July issue of the Mayo Clinic Proceedings, they urge administrators to close the "gaps in prevention, detection and response" that allow drug diversion to put patients at risk of not receiving prescribed doses, of impaired care and of infection transmission.
"The outbreaks we have identified illustrate some of the devastating and wide-reaching impacts of drug diversion in U.S. healthcare settings," write Melissa K. Schaefer, MD, and Joseph F. Perz, DPH. "Healthcare facilities should ensure that patients safely receive medications as prescribed. This effort includes having systems in place to prevent drug diversion as well as developing protocols for early detection and appropriate response if, despite safeguards, diversion does occur."
Their prescription for increased patient safety include security and monitoring measures, to deter diversion, as well as prompt reporting to law enforcement and assessment of patient harm in the event that it should arise.