Download Cuyuna Regional Medical Center`s Drug/Alcohol Free Workplace

Cuyuna Regional
Medical Center’s
Drug/Alcohol Free
Workplace and
Testing Policy
Welcome…. Let’s learn about Cuyuna Regional Medical Center’s
Drug-Free Workplace and Testing and Diversion Prevention Policies
Purpose
- Inform all employees of the Drug /Alcohol Free Workplace and
Testing Policy
- Prevent and increase awareness of diversion
- Increase awareness of addictions
- Share expectations of employee responsibility in maintaining a
drug/alcohol free workplace
Objectives
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Articulate the expectations of the Drug/Alcohol Free
Workplace and Testing policy
Describe the process to report suspected impairment
due to drug, alcohol or substance abuse – or to report
if you think someone is diverting (stealing) patient
medication
List behaviors that may indicate impairment on the
job
Discuss criteria for drug testing
Review the definition of “under the influence”
CRMC Drug – Free Workplace Policy
CRMC is committed to
providing quality health care
services and acknowledges
the importance of each
employee to the effective
function of a competent
health care team.
Policy Review
Cuyuna Regional Medical Center and its Longville and Baxter clinics prohibit
the use, possession, transfer, and sale of alcohol and illegal drugs while working,
while on all premises owned or operated by the Medical Center, and while
operating any medical center vehicle , machinery, or equipment. It also prohibits
reporting for work and working anywhere on behalf of CRMC under the
influence of alcohol or illegal drugs. This policy applies to all official or
unofficial break and meal periods, and all other times during the working day in
which an employee has reported for work, including unpaid meal breaks.
The use and possession of properly prescribed drugs or medications is permitted
provided that it does not interfere with the employee’s job performance or pose a
direct threat to the health or safety of the employee and/or others. Please discuss
with employee health.
Glossary
Alcohol & Other
Drug Abuse
Controlled
Substances
• Use of mood-altering drugs, including all forms of alcohol,
narcotics, depressants, stimulants, hallucinogens, marijuana or
the use of prescription drugs when resulting behavior or
appearance adversely affects work performance.
• Includes those substances whose distribution is controlled by
regulation or statute including but not limited to narcotics,
depressants, stimulants, hallucinogens and cannabis.
• A urine drug collection in which results reveal insufficient
concentration for determination of test results.
Dilute Specimen
Drug Diversion
Drugs of
Abuse/Mood
Altering Drugs
Health
Professionals
Services Program
• The theft of controlled substances or other medications from the
organization’s supply or from a patient’s supply, for purposes of self
administration, selling or other use.
• Alcohol, narcotics, depressants, stimulants, hallucinogens, marijuana
and any prescription drugs that interfere with the employee’s ability to
safely and effectively perform job duties, or pose a threat to the safety
of the employee or others, including patients.
• A state funded program recognized by multiple Minnesota regulated
health professional boards that promotes early intervention, assists
health professionals in obtaining care, provides monitoring and assists
in preserving careers.
Impaired
Behavior
• Behavior that MAY indicate impairment:
• When employee performance is inhibited
• Drowsiness and/or sleepiness
• Odor of alcohol on breath
• Slurred/incoherent speech
• Unusually aggressive or bizarre behavior
• Unexplained change in mood
• Lack of manual dexterity
• Lack of coordination in walking
• Unexplained work-related accident or
injury
Reasonable
Suspicion
Suspicion of
Others
Under the
Influence
•The basis for forming a belief based on specific facts and rational inferences drawn
from those facts.
•CRMC employees are required to immediately notify their appropriate supervisor
if they believe any employee or member of the healthcare team is not in
appropriate mental and/or physical condition to safely perform his or her duties.
•Shall be determined to be present if the individual is perceptibly impaired; has
impaired alertness, coordination, reactions, responses or effort; if the individual’s
condition threatens the safety of employees, patients or visitors; or if the
employee’s condition or behavior presents the appearance of unprofessional,
irresponsible, or unsafe conduct detrimental to the public's perception of CRMC
as determined by the supervisor, manager or department director.
Voluntary
Disclosure
• Individuals are encouraged to voluntarily
disclose the use of drugs and/or the misuse
of alcohol before being confronted, tested
or otherwise involved in drug and/or
alcohol-related discipline or proceedings.
An individual who does so will be granted
time off for treatment, rehabilitation or
counseling in accordance with the current
labor agreements or CRMC’s non-contract
policies. An employee who voluntarily
discloses the use of drugs and/or the
misuse of alcohol before being confronted,
tested or otherwise involved in drug and/or
alcohol related discipline or proceedings
will not be discriminated against because
of this disclosure. This information will
not be used as the sole basis for corrective
action, except where the employee has
previously tested positive.
CRMC sees substance abuse as a very serious problem and
threat to employees, volunteers, patients and visitors.
During work hours, both on and off the medical center premises, no employee or volunteer shall manufacture,
distribute, dispense, possess, sell, use, or be under the influence of any illegal drug or alcohol. Additionally,
employees and volunteers shall not engage in these activities during rest and meal breaks or while taking offpremise calls.
Why do we have a Drug/Alcohol Free Workplace and testing policy?
The ultimate goal of this policy is to balance our respect
for individual privacy with our need to maintain a safe,
productive, drug/alcohol free work environment.
CRMC is committed to maintaining a work environment
free from the influence of alcohol and/or drugs to protect
the health, safety and well being of patients, employees,
volunteers and visitors. CRMC complies with the
requirements of the Drug – Free Workplace Act of 1988.
CRMC employees are required to
immediately notify their appropriate
supervisor if any employee, volunteer, or
member of the health care team is not in
appropriate mental and/or physical
condition to safely perform their duties.
If you suspect impairment, do not allow
them to perform ANY procedure!
Which of the following indicates an employee, volunteer, or member of
the health care team is under the influence?
Smell of Alcohol
Motor skills issues
Performance/attendance issues
High/unusual patterns of access to controlled
substances
A member of the health care team has displayed behaviors indicating
she may be under the influence. What will occur first?
The individual is subject to testing for
reasonable suspicion.
When an individual is subject to testing due to reasonable
suspicion he/she will be:
a. Relieved of his/her work responsibilities
b. Escorted to the CRMC Laboratory Department for
specimen collection
c. An individual who refuses to be tested, or whose behavior prevents
meaningful completion of the testing such as tampering with the sample or
testing materials – behavior intended to provide a dilute sample, failure to
provide specimen within a reasonable amount of time (3 hours from initiation of
testing) or provide the required amount (30 cc), will be subject to termination,
other disciplinary actions, or have the employment offer revoked.
d. For the individual’s safety, arrangements may be made for:
1. Transportation: the individual will be sent home with a sober
adult (family member, friend, or via a transport service – paid by
CRMC).
2. If he/she insists on driving self home, city law enforcement
will be notified.
e. The individual will remain off work on paid administrative leave until all
drug testing results are received and confirmed.
Can an individual refuse to undergo testing?
Yes, an individual has a right to refuse testing.
The individual may refuse to undergo testing. However…All individuals
requiring testing will:
1. Be offered/given a copy of the CRMC Drug Testing Policy.
2. Be given the opportunity to read and ask interpretive questions.
3. Sign the Consent form and Controlled Substance and/or Alcohol Test
Notification form.
4. Be given the right to refuse testing but told the consequences of
refusing which could include termination.
5. In the case of a diluted specimen, recollection will be required. If
this second sample also tests diluted or there is a refusal to test, the
job offer will be rescinded for applicants and the test considered
positive for employees.
Cuyuna Regional Medical Center Commitment
Cuyuna Regional Medical Center is committed to
assisting employees who are suffering from
substance abuse problems.
Diversion Prevention and Reporting
Diversion of Drugs
Professionals suffering from addiction
often exhibit similar unusual behaviors.
Certain signs and symptoms may
indicate a drug addiction problem in a
health professional.
When a health professional is suffering
from addiction, the hospital drug supply
is sometimes misused as a source for
personal drug supply. This is called
drug diversion and is grounds for
immediate termination.
Diversion
 Intentionally and without proper authorization, using or taking
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possession of a prescription medication or medical gas from
CRMC supplies, CRMC patients, or through the use of CRMC
prescription, ordering, or dispensing systems. Examples of
drug diversion include, but are not limited to, the following:
Medication theft
Using or taking possession of a medication without a valid
order or prescription
Forging or inappropriately modifying a prescription
Using or taking possession of medication waste, e.g., left over
medication
Have you observed any of the following symptoms in
any of your co-workers?
Uses the maximum PRN dosage when other nurses
use less
Maximum PRN dosages are used by one nurse
consistently but not by other staff
Insistence of personal administration of injected
narcotics to patients
“If anybody needs help passing their pain meds today
let me know.”
Those are just some signs and symptoms of a drug impaired co-worker and
should cue you to pay attention to what is going on with your co-worker.
Leadership at CRMC would like you to use the above list to help you help
your co-workers in their time of need.
Patients
Have you observed any of the following symptoms in
any of your co-workers?
Patients state that pain medication was not given and
documentation supports pain medication had been
administered
Has responsibility for patients who complain pain
medications given by one staff member are not as
effective as those given by another staff member
“The patient must have forgotten.”
“He must have a low pain tolerance.”
If the patient states that he or she received no pain medications for several hours but the
documentation states that pain medication has been administered, this is the time to check
with the co-worker. If your co-worker has the responsibility for a patient who is
complaining that their pain medications are not effective when given by one staff member as
opposed to another staff member, this is another time for you to be keyed up to check on
your co-worker and perhaps talk with your leadership.
Documentation
Have you observed any of the following symptoms in
any of your co-workers?
Frequent wastage of drugs for “spillage”
Sloppy record-keeping
Documentation of medication given does not match
patient report
Uncharacteristic deterioration of handwriting or
charting
Absenteeism
Have you observed any of the following symptoms in
any of your co-workers?
Excessive absenteeism is common in end-stage
addiction
Frequent disappearances from the work-site.
Frequent or long trips to the bathroom
Excessive amount of time spent near a drug supply
Appearing at work when not scheduled
Personality Changes
Have you observed any of the following symptoms in
any of your co-workers?
Confusion, memory loss, difficulty concentrating
Interpersonal relationships with colleagues, staff and
patients deteriorate
Rarely admits errors or accepts blame for mistakes
or oversights
Personality change: mood swings, anxiety,
depression, lack of impulse control
Patient and/or staff complaints about health care
provider’s attitude and behavior
Committed to a Drug/Alcohol Free Workplace
What does this mean?
CRMC is committed to providing quality health care
services and acknowledges the importance of each employee
to the effective function of a competent health care team.
Cuyuna Regional Medical Center is also committed to
providing the highest level of patient and employee safety.
CommitmentI commit to a drug/alcohol
free workplace at Cuyuna
Regional Medical Center!
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