Development of a Policy and Procedure for Random Drug Screening of Healthcare Workers at a Tertiary Care Childrens Hospital: Initial Implementation and Preliminary Results

Kayla E. Pfaff, Chester Kaczor, Patrick McKenna, Joshua C. Uffman, Joseph D. Tobias


During the past decade, substance abuse and addiction have continued to increase worldwide in both the general public and healthcare providers. Given the ongoing trend demonstrating an increase in the prevalence of drug diversion and its higher prevalence in various healthcare provider groups, several interventions have been initiated to decrease the availability of substances of abuse, as well as identify or uncover substance abuse in healthcare providers. This manuscript reviews techniques which have been implemented to prevent diversion in healthcare providers and outlines the steps taken in the development of a random drug screening program at our tertiary care childrens hospital. Additionally, we review outcomes and the potential impact after the first 24 months of the random drug screening program. Six faculty or staff have been screened each quarter over a 2-year period. To date, we have not had a positive result. Service issues regarding timely screening of faculty and staff upon arrival to Employee Health have been limited with the process generally taken less than 60 min. There have been no significant disruptions in the work process of the operating room or pharmacies. The use of random drug testing is important not only for the safety of our patients, but the integrity of both the fields of anesthesia and pharmacy. The process can be introduced without interruption of workflow or impact on employee privacy. We believe that this process is one of several interventions which may be helpful in decreasing drug diversion.

Int J Clin Pediatr. 2022;11(3):69-75


Opioid use disorder; Substance abuse; Addiction; Diversion; Random drug screening

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