Pharmacy reports that the medication records of a unit have begun to show frequent corrections

Question

What other signs of diversion would the manager look for on the unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Chart review on effectiveness of pain control
2. Increase in clients with conditions requiring pain medications
3. Increase in use of doses of as-needed narcotics that results in wastage
4. Chart review that reveals that clients require much more narcotic pain medication on one shift than on others
5. Narcotic containers that look as if they have been altered

Answer 1

1,3,4,5
Rationale 1: If many clients report their pain is not controlled, diversion may be occurring.
Rationale 2: An increase in clients requiring pain medications is likely census related.
Rationale 3: If the nurse has a choice of doses and is trying to divert medications, a smaller dose might be given resulting in a larger wastage that is then diverted.
Rationale 4: If one shift is giving much more pain medication that the other, it may be because someone is diverting drugs on that shift. It may also mean that inadequate pain control is being given on the other shift because someone is diverting drugs.
Rationale 5: Altering the container is a method of diversion.
Global Rationale: