ATrain Education

 

Continuing Education for Health Professionals

FL: Impairment in the Workplace

Module 7

Employer Initiatives/Prevention

Employers have an important role in combating substance use disorder and also in helping to prevent it. Proactive efforts by employers to promote safety and provide assistance can protect patients and support staff, and preserve the institution’s financial well-being and community standing.

Possible actions facilities can take include adopting open, transparent, and comprehensive policies and procedures, offering classes or seminars on substance use disorder and other topics, and creating an internal structure that supports nurses and other healthcare professionals who do the right thing. Hospitals and other facilities with custody of controlled substances have an obligation to establish policies and procedures to combat drug diversion aggressively.

Employee Assistance Programs (EAPs) are an option employers can use to address several needs. EAPs can provide a program for supplementary education for nurses and staff of all levels about substance use disorder—what it is, how to recognize it, and how to take action when it affects the workplace. EAPs can also provide connections to counseling and assistance to help employees address a myriad of problems—mental, physical, professional, personal—that might otherwise act as temptations to turn to substance use as a coping mechanism.

Onsite offerings could include exercise classes or training in stress reduction techniques. Health promotion programs can offer incentives for staff to develop new healthy habits for exercise, stress reduction, weight loss, and smoking cessation. We’ve already seen that these kinds of programs and activities act as protective factors against substance use disorder.

Healthcare facilities need to actively create an environment that encourages and supports reporting of workplace impairment with zero tolerance for retaliatory action by anyone. Managers need to be well trained in legal requirements and facility policies and procedures and they should be required to share that knowledge with those they supervise through group discussions and role-playing activities to increase comfort around recommended actions and help establish open communication between staff members.

At the same time, facilities need to establish an environment that respects nurses and provides support for those dealing with substance use disorders from the perspective that it is a disease that is treatable and there is the potential for the nurse to return to the workplace after successfully completing treatment (Strobbe & Crowley, 2017).

Depending on the community and situation a facility may find that community outreach activities to explain how the organization works, what it is doing to combat substance use disorder among all populations, and encouraging community participation in actions to reduce risks and increase protective factors will work to the benefit of everyone.

Drug Diversion Prevention

Facilities need to work with all relevant local, state, and national organizations to make sure that their drug diversion prevention activities are fully up-to-date. There is no perfect system that will catch everything, but vigilance is critical.

Writing for the CDC Safe Healthcare Blog, an investigative specialist offered this summary:

Diversion of controlled substances happens at all institutions. Because diversion can’t be stopped entirely, facilities must prevent it to the extent they can, identify cases quickly, and respond appropriately.

The essential elements of a healthcare facility diversion program include

  • Policies to prevent, detect, and properly report diversion,
  • A method of observing processes and auditing drug transaction data for diversion,
  • Prompt attention to suspicious audit results,
  • A collaborative relationship with public health and regulatory officials, and
  • Diversion education for all staff (CDC, 2014)

As we have noted previously, lack of knowledge about substance use disorder and its signs is a critical part of the challenge for nurses but it reaches everyone. Investigation of a diversion incident in New Hampshire revealed that even highly educated and well-trained staff were either not properly educated about substance use disorders or were not motivated to fully follow established policies for dealing with staff SUD problems (CDC, 2014).

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