The Impaired Healthcare Worker Lake Regional Health System

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   LRHS HR Policy number defines the impaired worker as an employee affected by drugs, alcohol, or both in a detectable manner where such use or influence may affect the safety of the employee, coworkers, patients, or members of the public, as well as the employee’s job performance or the safe efficient operation of the facility.   According to OSHA, 65% of all work-related accidents can be traced to substance abuse.

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   While 10 percent of the general population is addicted to alcohol or drugs, that number rises to at least 12 percent among all types of health-care workers. Most clients in recovering professionals program in the US have abused prescription drugs-60% of them opiates followed by benzodiazepines, like Valium. Others abuse alcohol or other prescription drugs, such as Ritalin, while street drugs account for about 1% of clients.

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   Many healthcare workers have easy access to controlled substances and some will divert and abuse these drugs for reasons such as relief from stress, pain, or to improve work performance and alertness. Specific groups of healthcare workers at higher risk of abuse and addiction are critical care, emergency department, OR, and anesthesia professionals. High risk patients and procedures, long hours, poor sleep patterns, and poor coping strategies all increase the possibility of chemical abuse in these specialties.

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   Alcohol and drug abuse by an employee can create a variety of problems for the employer, coworkers, and clients. First and foremost, healthcare workers have a personal and professional responsibility to ensure patient safety.   Recognizing signs of impairment and reporting a potentially drug impaired coworker to a supervisor and/or manager are immediate first steps to protect the safety of any patient in danger of physical or emotional harm by an impaired coworker.

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   Drug abusers often exhibit similar unusual behavior. The following signs & symptoms may indicate a drug addiction problem in a health care professional:     Absences from work without notification and an excessive number of sick days used.   Frequent disappearances from the work site; frequent or long trips to the bathroom or stockroom where drugs are kept.   Excessive amounts of time spent near a drug supply.   Volunteering for overtime and working when not scheduled.   Unreliability in keeping appointments and meeting deadlines.   Work performance which alternates between periods of high and low productivity; mistakes made due to inattention, poor judgment, and bad decisions.   Difficulty completing simple tasks, concentrating, or recalling details and instructions.   Deterioration in charting, handwriting, personal appearance.   Exhibits mood swings, depression, anxiety, or lack of impulse control.   Patient and staff complaints about changing behavior or attitudes.   Increasing personal and professional isolation.

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   Immediate interventions may include:   Offer to care for patient's while he/she goes on break.   Not reporting a suspected impaired coworker enables him/her to continue their addictive behavior and imperils patients.   Do not permit a visibly impaired worker to care for patients   Immediately report observations of unsafe practices or impaired behavior to the appropriate supervisor   Accurately and completely document any suspicious behaviors or incidents prior to confrontation.   Ideally, the suspected employee’s supervisor (in the presence of a third person) is the individual who confronts the employee of substance abuse.   Respect the healthcare workers’ right to confidentiality during the investigation process. Inappropriate disclosure of information or suspicions could be grounds for litigation, should the reputation of the healthcare professional be tarnished.   Be supportive, not judgmental; remember that substance abuse is a disease

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   According to LRHS policy:   An employee with suspected impairment at work may be required to submit to drug and/or alcohol screening.   The employee will be given the opportunity to provide information that may help explain positive test results.   Prior to initiating questioning relative to use or possession, managers should consult with human resources, if available.   Managers must have another individual in a supervisory role present, and follow the Suspected Substance Abuse questionnaire contained within HR policy #

THE IMPAIRED HEALTH CARE WORKER THE IMPAIRED HEALTH CARE WORKER   According to LRHS policy:   If an employee tests positive, or admits to substance abuse he/she must not be allowed to return to work or to drive away from the hospital. The manager should request permission to call a friend or family member, or make other arrangements for transportation to home.   If the employee refuses and leaves the premises, the manager document the refusal and subsequent action.   Employees who are injured on the job, cause damage to hospital property, and/or cause an accident or injury to one or more employees will be required to submit to a drug/alcohol screening immediately following the occurrence.   LRHS may, at any time elect to conduct random screenings, including those required by State and Federal Laws, on any or all employees.

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