Chain of Custody
RN Chain of Custody
What is who had the controlled substance at what time?
Extended time off-unit, frequent restroom breaks
What are signs of possible diversion?
Law enforcement intervention versus medical and psychosocial services?
What is the discretion an organization may or may not have when diversion is identified?
Log in with user ID, password, and fingerprint biometric, followed ONLY by fingerprint access.
What is the Omnicell log-on workflow, starting with 1st log-on of the day?
Ext. 6000
What is the number to call an RRT?
The time period to witness a waste, return, or refill/restock
What is real-time?
What is the Diversion Response Team?
Insurance Fraud
What may healthcare facilities and clinicians be charged with if controlled substances are diverted from patients for whom they were intended?
Fulfilling a colleague request to co-sign a waste at Omnicell when the waste isn't currently present
What is an unwitnessed waste of a controlled substance?
The nurse can use the Zoll defibrillator in this mode without an APP present.
What is the advisory (AED) mode?
The Chain of Custody begins and ends
What is from Omnicell removal to patient administration?
Report immediately to Nurse Leader or Nursing Supervisor, Security and completes a RISQ report.
What is any amount of controlled substances that becomes unaccounted for or the loss unexplained?
Hepatitis C
What is the most prevalent infectious organism transmitted via diversion of IV controlled substances in healthcare settings?
FDA standard for non-retrievable, water-source, for drug disposal.
Unique identifier "T" in a user ID
What is Traveler RN username access to the Omnicell?
Getting around the Chain of Custody
What is sharing username and password?
According to the National Council of State Boards of Nursing, this is a red flag for diversion.
What are variations in controlled substances discrepancies among shifts or days of the week?
The 3 components of controlled substance handling privileges.
What are Prescribing, Dispensing, and Administering?
According to the American Society of Health-System Pharmacists (ASHP) "Any unresolvable discrepancy is considered a possible diversion and escalated to investigation"
What is when Practice Drift or Workarounds are investigated as possible diversion?
What is the unaccounted for, or unexplained loss of, any amount of a controlled substance?
A break in the Chain of Custody
What is leaving a controlled substance anywhere unattended, including at the patient's beside?
Controlled substance waste NOT witnessed at the Omnicell
What are controlled substances medication patches?
Heightened surveillance
What is DEA, BNE, and DOH response to an organization's unaccounted for controlled substances?
Neuroscientists and the evidence
What is the hard wiring of the human brain to "drift" in all areas of life and work?
Exceptions to policy, allowed to have 3 components of controlled substances handling.
Who are Outpatient Men's Sexual Health Nurse Practitioners, NPs working as a per diem nurse, and Certified Registered Nurse Anesthetists.