Chapter 4 Control Substace Diversion Flashcards
In organization, where controlled substances are used, all staff should be educated about Controlled Substances, Diversion, Prevention program (CSDPP) , including:
Including :
-leadership oversight.
-legal and regulatory requirements.
-Monitoring and surveillance
-Automation and technology.
-Pharmacy controls.
It can be defined as any criminal act or deviation that removes a prescription drug from its intended path from manufacturer to the intended patient
Drug diversion
Example of common risk ,points, and methods of diversion:
:
-purchase order and packing slip removed from the record.
-Unauthorized individual orders for CS on stolen DEA form 222
-Product container is compromised
1-Procurement
2 . Example of common risk points and methods of diversion
— CS replaced by product of similar appearance when packaging
— removing volume from premix infusion.
— multi-dose vial OVERFILL overfilled diverted.
— preparer syringe contents are replaced with saline solution
preparation and dispensing
3-examples of common risk points and methods of diversion:
-prescription Pat diverted and forced to obtain CS
-Prescriber self-prescribes CS
-Verbal order for CS credit, but not verified by prescriber
-Written prescriptions altered by patients
3-Prescribing:
4-example of common risk points, and method of diversion:
CS is a withdraw from an ADD on discharged or transferred patient
-medication documented as given, but not administered to patient.
-Waste is not adequately witnesses or subsequently diverted.
-Substitute drugs is remote an image search while CS is the diverted
5-examples of common risk points and methods of diversion:
— CS waste is removed from unsecure waste containment.
— she is waste in with syringe is replaced with saline
— expired CS are diverted from holding area
5- waste and removal:
Opportunity for drug diversion
- 6 ways:
1-failure to waste.
2-wasting entire doses.
3-delayed wasting to facilitate substitution.
4-deliberate removal of a large does the necessarily.
5-Premature replacement up PC eighth and trips.
6-theft from Sharper containers
Failure to waste :
3 ways:
1-failure to waste occurs when only a portion of a single use product is necessary to provide. They ordered dose
2-the remainder should be disposed of properly
3-most institutions have procedures in place, such as requiring a “waste buddy” or a second healthcare, professional, that what does this and document in disposal 
A coworker or healthcare for Fessional that shows as the second person, and a witness to the destruction or removal of controlled substance wastes
Definition : waste buddy”
Opportunity for drug diversion
Theft From sharps containers
Which of the following would warrant investigation or civilians related to potential controlled substances diversion ?
A-recognizing the weekend shift is feeling red sharp container beyond recommendation capacity
B-a compounding technician only disposes of hazardous product syringe in yellow sharps container.
C-sharps, container, controlled substance waste, and so we just with tamper-evident tops that have been compromised.
D-none of the above warrant investigation or surveillance 
Answer :
C-sharps, container, controlled substance, waste and syringes with tamper- evident tops that have been compromised
5:
1-accessing medication when it is not needed.
2-removing medication for a patient who has already discharge.
3-removing a duplicate dose
4-reusing a fentanyl patch
5-using a colleague’s , locking to access the ADC
1-accessing medication when it is not needed.
2-removing medication for a patient who has already discharge.
3-removing a duplicate dose
4-reusing a fentanyl patch
5-using a colleague’s , locking to access the ADC 1-accessing medication when it is not needed.
2-removing medication for a patient who has already discharge.
3-removing a duplicate dose
4-reusing a fentanyl patch
5-using a colleague’s , locking to access the ADC
Opportunity for job diversion
which of the following is an example of drug diversion?
A-were using fentanyl patches because they contain a significant amount of fentanyl after used
B-accessing an automated dispensing cabinet using a coworker passcode.
C-asking a patient’s son if he understands how set a new patches are to be apply and then disposed after 72 hours.
D-both A and B example of drug diversion
Answer:
D- both A & B are example of Drug diversion
1-falsifying a verbal or electronic order.
2-tampering or substitution
Opportunities for drug diversion
which of the following is a correct statement?
A-evidence suggests that Pharmacist I always ethical and never complicit in drug diversion .
B-only pharmacy technicians have been identified in the diversion of control substances.
C-pharmacist have been played guilty to a crime involving drug diversion.
D-none of the above are accurate statement
Answer.
C-Pharmacist have played guilty to crimes in the truck diversion
1-the lead technician removed, morphine sulfate in Hydromorphone hydrochloride from a violent intended for using in mix IV bag.
2-he diluted the vials to hide
his theft
3-he prepared the vast majority of CRXI’s IV bags, which helps safeguard his scheme
Signs of product tampering, and or alteration
Which of the following is true?
A-I Pharmacy Technician’s are positioned in area of trust such , that if they are draw a syringe and set is beside a vial of a controlled substance, it is assumed the syringe contains the Contant of the vial of that controlled substances
B-I pharmacist rely on and trust technicians such that the pharmacist Rea has reason to question that the actual indicated product and quantity has been injected into the IV bag to be administered.
C-technicians perform the work, and know that process so well that they know what is necessary to convince a pharmacist, if they have devious intention
D-all of the following accurate statement
Answer.
D-all of the following are accurate statement.
Healthcare providers, who still prescription, medicines or controlled substances such as opioids for their own use put patient at risk.
Consequences of tampering with injectable:
This can result in several types of patients harms, including :
1-substandard care delivered by an impaired healthcare provider
2-denial of essential pain medication or therapy.
3-risk of infection (example: with hepatitis C virus or bacterial pathogens)
Which of the following is a consequence of tapering with injectable?
A-the injection will sting and leave a purple bum.
B-there are none, so long as the content replaced with tapwater.
C-a patient in my experience paining when it is assumed he or she is receiving an order those of medication.
D-patient may become addicted to the tampered injectable
Answer.
C-a patient in my experience paining it is assumed he has he is receiving an order dose of medication
What is drug assay sampling?
Tempering was discovered when an employee of the pharmacy detected irregularities in a certain vials of drug.
— after the tempering was discovered, some of the wild, where analyzed by an independent laboratory and found to be substantial below their labor strength
Suspicious practices, techniques and suspicious data patterns:
1-technology designed to prevent drug diversion.
2-read reconciling Tatian of invoice to purchase history report
3-record audits.
4-checklist to verify all paperwork is complete
BD Health-Sight, supported by Microsoft, utilize machine learning algorithms and dispensing behaviors, such as overrides, canceled transactions, dispensing, delays, and Mr. medication and waste medication children defy, potential diversion… Looking at multiple signals… Looking for anomalies ( some thing that deviate stand out, not normal or expected)
Technology designed to prevent drug diversion
BD health looks for anomalies using :
A-algorithms( process or a set rule to follow in calculation of all the problems. solving operation) that include dispensing behaviors.
B-algorithm that access overrides
c-algorithms that access canceled transactions
D-algorithms that asses waste medications.
E. All of the above are true
Answer
E-All of the above are true
