Guidelines for the prevention and detection of controlled substance diversion.

Controlled substance diversion is a problem all hospitals face with far ranging legal and medical implications. Drug diversion or tampering can take many forms, such as simple theft, theft by substitution, theft by charting, and under-medicating the patient. The diversion of controlled substances by professional staff from patient care areas can frequently be prevented and detected at the nursing staff level. Often, diversion can be detected in daily hospital practice by performing careful narcotic counts, witnessing the "wasting" of partial doses, and routinely examining product packaging. Such procedures should be hospital policy and strictly enforced. Use of the guidelines presented in this report in conjunction with an effective inservice program can educate health care professionals in the problem of drug diversion. Drug diversion must be reported to maintain patient care standards, employee morale, and ultimely provide the necessary help and guidance to an impaired staff member.