ASHP Chapter 4 Surveillance and Investigation

Question 1

Diversion: 6

Answer 1

1-procurement
2-preparation/dispensing
3-prescribing
4-administration
5-waste
6- documentation

Question 2

Purchase order and packing slip removed from record.
Unauthorized individual orders for CS and stolen DEA 222
Claude and contain his compromised . (What does shipping of any damage.)

Answer 2

Procurement

Question 3

-CS are replaced by product, similar appearance when pre-packaging
-Removing volume from premix infusion
-Multi-dose vial overfill diverted
-Prepared, syringe contents, replace with saline solution

Answer 3

Preparation and dispensing

Question 4

Prescriptions pads are diverted and forged to obtain CS
prescriber self prescribed CS
Verbal orders for CS created but not verified by prescriber.
Written prescription I’ll just by patient s

Answer 4

Prescribing

Question 5

CS withdraw from an ADD on discharge or transfer patient
Medication documented given, but not administered to patient
Waist is not adequate three witnesses subsequently diverted
Substitute address is removed on, and CS diverted

Answer 5

Administration

Question 6

Cs waste is removed from unsecured waste container.
CS waste in syringe is replace with syringe yet.
Expired CS is a diverted from holding area.

Answer 6

Waste and removal

Question 7

Chain of custody :5

Answer 7

1-Procure drug
2-receive drug
3-prescription order.
4-dispense or administer
5-final documentation

Question 8

1-work additional shift.
2-higher than average control substance removal.
3-higher than average controlled substance wastes.
4-discrepancy.
5-missing DEA 222 forms.
6-change it work performance.
7-change in personality and personal appearance.
8-inconsistent prescribing habit

Answer 8

Signs of tampering or alteration

Question 9

Surveillance tracer technique : 6

Answer 9

Purchase
Receive.
ADC load
Removed.
Administerer.(. Verify with medication administration record MAR)
Waste. (Verify wouldn’t of the waist to look for Trends

Question 10

-anomalous usage report.
-Perpetual inventory report
Automated dispensing cabinet activity report.
Witness or waste reports.
Discrepancy reports.

Key points:

1-single report will not house answer.
2-capturing data and reporting takes time
3-pain contracts

Answer 10

Surveillance report

Question 11

1-tempered, seal broken
2-package for orders arrived with shipping packet, open or resealed
3-plastic tamper evident numerical seals does not match paperwork
4-reports of uncontrolled pain from patients

Answer 11

Signs of tampering or alteration

Question 12

1-Validate authenticity of injectable controlled substance waste
2-conduct routine audits—samplings injectable waste
3-conduct audit, when known diversion has occurred

Answer 12

Tampering and refractometer

Question 13

Prescriptions abuse

Answer 13

Opioids + + benzodiazepine +carisoprodol = “Holy Trinity”

Question 14

What is PDMP?

Answer 14

It is prescription drug monitor program.

Question 15

Database continuing information
1-provider prescribing habits.
2-patient dispense history across pharmacy

Answer 15

Prescription drug Monitor programs called PDMP

Question 16

Provider
Patients
Healthcare workers.

Answer 16

Prescription fraud

Question 17

Tampering resistant prescription paces: 4 ways help prescription source validation:

Answer 17

Prescription source validation

1-use off PDMPs to verify provider and patient
2-access to the HR verify. The provider wrote prescription for the patient.
3-contact the provider directly for verification
4-if the patient is not know, always check the patient’s identification

Question 18

Always do -diligence,
-awareness m
-Surveillance

Question 19

Surveillance reports

Answer 19

1-anomalous usage report.
2-perpetual inventory reports
3-automated dispensing cabinet activity report.
4-witness or Wast reports
5-discrepancy reports

. Key points.
1-single report will NOT have answers.
2-capturing data and reporting take time