Closing the surveillance gap: Development of a technology-integrated model for nurse anesthesia student controlled substance oversight

IF 6.3 4区 医学 Q1 NURSING
Jennifer R. Majumdar PhD, CRNA , Jennifer G. Carroll DNP, CRNA, CENP, CPHQ, FACHE , Keith B. Denison DNP, CRNA , Hallie J.D. Evans DNP, CRNA, APRN, CNE, FAANA
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Abstract

Controlled substance (CS) diversion poses serious risks to patient safety, provider well-being, and institutional compliance, particularly in anesthesia practice where potent medications are routinely handled. Nurse anesthesia students are often entrusted with CS preparation and administration under indirect supervision but are frequently excluded from automated dispensing systems. When preceptors retrieve medications on students' behalf, transactions are recorded under the preceptor's credentials, eliminating individual accountability and rendering students invisible to surveillance systems. To address this oversight gap, a newly established nurse anesthesia program partnered with a large academic health system to design a standardized, technology-enabled oversight framework. The model will provide each student with role-based, time-limited system credentials synchronized to clinical rotation schedules, ensuring that all CS transactions—dispensing, administration, and waste—are traceable to the individual performing the task. The framework's five pillars—interprofessional collaboration, standardized policy, annual diversion prevention education, analytics-based surveillance, and clear reporting pathways—align with best-practice recommendations from the American Society of Health-System Pharmacists and standards from the Drug Enforcement Administration and The Joint Commission. Although full implementation is pending, this proactive approach exemplifies a scalable, systems-based solution that strengthens diversion prevention while serving as a pedagogical imperative. Furthermore, embedding students in the same surveillance infrastructure as licensed providers prepares them for the regulatory realities of modern healthcare and sets a new standard for safety, accountability, and professional integrity in anesthesia education. This report describes the pre-implementation phase of this quality improvement initiative, highlighting the rationale, development, and expected benefits and challenges of the framework.
缩小监督差距:开发一个技术集成模型的护士麻醉学生控制物质的监督
受控物质(CS)转移对患者安全、提供者福利和机构依从性构成严重风险,特别是在常规处理强效药物的麻醉实践中。麻醉护士学生经常被委托在间接监督下进行CS的制备和管理,但经常被排除在自动配药系统之外。当指导员代表学生取回药物时,交易记录在指导员的证书下,消除了个人责任,使学生对监控系统不可见。为了解决这一监督缺口,一个新建立的护士麻醉项目与一个大型学术卫生系统合作,设计了一个标准化的、技术支持的监督框架。该模型将为每个学生提供基于角色的、有时间限制的系统证书,与临床轮换时间表同步,确保所有CS事务(分配、管理和浪费)都可追溯到执行任务的个人。该框架的五大支柱——跨专业合作、标准化政策、年度预防转移教育、基于分析的监测和明确的报告途径——与美国卫生系统药剂师协会的最佳实践建议以及美国缉毒局和联合委员会的标准保持一致。虽然尚未全面实施,但这种主动的方法是一种可扩展的、基于系统的解决方案,可以加强分流预防,同时也可以作为教学的必要条件。此外,将学生纳入与有执照的提供者相同的监督基础设施中,为他们适应现代医疗保健的监管现实做好准备,并为麻醉教育的安全性、问责制和专业诚信设定了新的标准。该报告描述了该质量改进计划的实施前阶段,强调了框架的基本原理、开发以及预期的好处和挑战。
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来源期刊
CiteScore
4.60
自引率
12.50%
发文量
50
审稿时长
54 days
期刊介绍: Journal of Nursing Regulation (JNR), the official journal of the National Council of State Boards of Nursing (NCSBN®), is a quarterly, peer-reviewed, academic and professional journal. It publishes scholarly articles that advance the science of nursing regulation, promote the mission and vision of NCSBN, and enhance communication and collaboration among nurse regulators, educators, practitioners, and the scientific community. The journal supports evidence-based regulation, addresses issues related to patient safety, and highlights current nursing regulatory issues, programs, and projects in both the United States and the international community. In publishing JNR, NCSBN''s goal is to develop and share knowledge related to nursing and other healthcare regulation across continents and to promote a greater awareness of regulatory issues among all nurses.
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