Exeter Hospital employee led to an outbreak of hepatitis C - Page 3
Register Today!- Asst. Admin
Jun 16, '12 by Esme12Quote from Prima FacieAgain...this has not been proved to be from diversion. Nanny cam's are in the PRIVACY of one's home. If you click on the stars on my profile you will see that I have been a nurse 34 years this month. I have practiced through amazing advances in medicine and I agree who knows what the future holds.Had another thought that related to this......What about those nanny surveillance systems?
Everyday, another babysitter is caught abusing a child, and it's all caught on the nanny-cam.
Concrete evidence, she shook that baby.
Fired
Arrested
imprisoned (hopefully)
------------------------------------------------------------------------------------------------------------------------------
There is SO MUCH substance abuse by nurses, there has to be a better solution than a electronic sign out machine.
Maybe hospitals need pain management teams who administer all narcs.
-Remove the narcs from the floor nurses reach.
-Pain management team does regular drug testing as part of the requirements to stay on the team.
-Some will argue that this is a demotion of responsibilities to non addict nurses, but its really just the same as having an IV team.
Is that a viable solution?
The monitoring you mentioned "TV surveillance in ICU" is the EICU/Telemedicine concept and they are not widely used and may have a use in the future.... Let me google that for you I am unclear as to how that would stop this situation that "we" are talking about.
I hope that we as patients/humans/citizens of the US ever lose the right to privacy or lose the right to grant permission.
With the amount of medications given everyday the actual incidence of abuse is rather small. I would believe that routine random drug screening would become more popular before A "Narcotic Administration Team" will be necessary. Imagine the wait if you are in pain for the TEAM to respond. Imagine the wait for such nonsense in a critical care area, surgery, or Cath Lab is not an attainable goal.
I don't think we need to lower the standards and decrease the responsibility of nurses as we demand higher education of bedside nurses. I think the development of improved needless administration. Single dose administration will in the long run be the effective standard of practice.
This may be a case of cross contamination of a multi-dose vial. This may not have been a nurse at all. This may be an incidence of a huge systems error that need to be rectified.
So I do not agree that the removal of nurses responsibilites is the corrective action to take. - Asst. AdminJun 16, '12 by Esme12Quote from Prima FacieEMR data is breached ALL the time. Intentionally and unintentionally........having naked restless, intubated, coding and dying patients don't need to be on camera to be later viewed on YouTube.I just want to add, what is the difference of protecting all that EMR data from protecting video data?
None.wooh likes this. -
Jun 16, '12 by PrimaFacieGitano, You are very smart and perceptive, and I'm glad you weighed in on this discussion.
I hear what you are saying....so let's say this fictional (for now) Pain management team takes over all the narc administration in a hospital. As part of the requirement to be a member of this PM Team, they have to have weekly drug testing. This may sound excessive, but remember the idea is to eliminate any misuse and to be beyond reproach. The positions would be RN with special pain management training. Each floor would have their own PM nurse and those nurses would only do pain management and nothing else. Units and ED would share one.
Pain management for patients would probably improve.
Narcotic abuse would go to 0.
The spread of disease potentially caused by abuse of multi dose vials would be eliminated.
The only negative would be budgetary, paying another FTE for each area but that would have to be studied as far as it lightening the work load of the other nurses and time/monies spent on abuse, etc...
I really cant see a negative here with this soloution....maybe someone else can? - Jun 16, '12 by PrimaFacieQuote from Esme121. wow, congrats on 34 years!I am unclear as to how that would stop this situation that "we" are talking about.
With the amount of medications given everyday the actual incidence of abuse is rather small. I would believe that routine random drug screening would become more popular before A "Narcotic Administration Team" will be necessary. Imagine the wait if you are in pain for the TEAM to respond. Imagine the wait for such nonsense in a critical care area, surgery, or Cath Lab is not an attainable goal.
I don't think we need to lower the standards and decrease the responsibility of nurses as we demand higher education of bedside nurses.
So I do not agree that the removal of nurses responsibilites is the corrective action to take.
2. I am just trying to think of a solution - Some people (not you, but just saying) will complain, but me, my mind jumps to how do we provide a fix? This fix not only eliminates the potential of the contamination but addresses the huge problem of substance abuse by nurses in the system.
3. Nurses are always worried about their responsibilities being decreased, and at the same time, they are often complaining that we are so busy and overwhelmed. It does not remove the professionalism of nursing or lower the standards, to create specialties within our profession. ie: Diabetes educators, wound care specialists, etc.
4. If the pain management team is staffed appropriately, the wait for a narcotic shouldn't be any longer than the current system.
5. I disagree with your statement of: "....the actual incidence of abuse is rather small." I recently reviewed the public records of disciplinary actions on nurses in a few states where I am licensed, and they are mostly for substance abuse.....and there are gazillions of them.
6. It is ok to not agree, but I hope you are open minded should the situation ever present its-self as a reality. -
Jun 16, '12 by Sweet_Wild_RoseQuote from PrimaFacieImpossible. There are people so desperate for their fix that they will dig that syringe or vial out of the sharps bin for that fraction of a drop of what just might be their narcotic of choice. I've seen it happen. The cameras aren't going to be able to do anything unless there is an obscene number of them in each room to catch every possible angle no matter where anyone is standing/furniture placed/whatever. The risks here far outweigh the benefits when you consider the one in one million chance of catching someone diverting drugs vs something ending up on Facebook or YouTube that shouldn't. It's amazing what people don't already have the good sense not to post. This would just add to it.Narcotic abuse would go to 0. - Jun 16, '12 by PrimaFacieQuote from Esme12I fail to see how a single dose vial would eliminate the problem if the nurse used the needle on him/herself, refilled the syringe with saline, and then used it on the patient.Single dose administration will in the long run be the effective standard of practice.
This may be a case of cross contamination of a multi-dose vial. This may not have been a nurse at all. This may be an incidence of a huge systems error that need to be rectified.
And even if it was inside the multidose vial from this same practice (using the needle on him/herself and then sticking same needle into multidose vial) it is still a problem of shared needles starting the problem, and single dose will reduce the number of people infected but wont stop the problem.
ICK...the thought of this really upsets me. - Asst. AdminJun 16, '12 by Esme12It upset me to.....I think we need to see how this started before debating the solution. The thought of this is frightening for everyone. I inherently feel from a long nursing career that there is more to this story for it to have gone on for two years.
I smell something afoot.....
- Asst. AdminJun 16, '12 by Esme12Quote from Prima FacieThank You! It's been a great run, I've had an amazing career.1. wow, congrats on 34 years!
2. I am just trying to think of a solution - Some people (not you, but just saying) will complain, but me, my mind jumps to how do we provide a fix? This fix not only eliminates the potential of the contamination but addresses the huge problem of substance abuse by nurses in the system.
3. Nurses are always worried about their responsibilities being decreased, and at the same time, they are often complaining that we are so busy and overwhelmed. It does not remove the professionalism of nursing or lower the standards, to create specialties within our profession. ie: Diabetes educators, wound care specialists, etc.
4. If the pain management team is staffed appropriately, the wait for a narcotic shouldn't be any longer than the current system.
5. I disagree with your statement of: "....the actual incidence of abuse is rather small." I recently reviewed the public records of disciplinary actions on nurses in a few states where I am licensed, and they are mostly for substance abuse.....and there are gazillions of them.
6. It is ok to not agree, but I hope you are open minded should the situation ever present its-self as a reality.
Disciplinary actions of nurses for abuse can be alcohol as well. Diversion is a problem but when compared to the overall numbers of nurses is rather small. In 2006 the amount of nurses disciplines was 7,899 out of the 4,363,206 nurses registered (APN,PN,LPN,VN) which adds up to only 0.18%. This includes ALL reasons for discipline including offenses other than diversion/impairment.
So it actually, while the incidence has increased, so has the population of licensed nurses leaving it still an only 0.18% of all licenses granted are disciplined.
https://www.ncsbn.org/09_AnalysisofN..._Vol39_WEB.pdf
I think "a fix" needs to be explore when the causative facts are revealed and then a revised standard of care can be developed from this unfortunate and frightening turn of event. I have spent an entire career being open minder to change....so I think I'll adapt when the time comes.
I think a greater attention to the virulence of HEP C is going to be the lesson here. - Jun 16, '12 by PrimaFacieSome interesting facts from that study:
--Chemically dependent nurses usually work for several years before undergoing disciplinary action.
--Drug related violations represent 25% of all violations
--One-fifth (21%) of disciplined nurses recidivate;
But there are only disciplinary actions if they refuse to enter, or fail out of a program.The CA nurse diversion tx program has had "Over 1,200 registered nurses have successfully completed the program"
That is just CA. And all those nurses who went to programs, didn't find its way into the study because those nurses were not disciplined. (unless they went un-clean later and got caught)
So disciplinary actions research is not an accurate way to count all the nurses who divert, or have a narcotics issue.
But it was interesting research, all the same. - Asst. AdminJun 16, '12 by Esme12Good points.......
This thread is not about disciplining licenses it's about the HEP C scare in NH. It is not, however, a debate about nursing license discipline or limiting nursing practice. Personally I think being more selective about admittance into school and granting licensure might be a solution....one just never knows.
Again THIS incident may have NOTHING what so ever to do with diversion so time will tell if this conversation even needs to take place.
