WA Health Misconduct Handling Procedures - Corruption and Crime ...

… we started counting [Panadeine Forte] like Schedule 8 andthe problem [of unaccounted use] stopped… certainly the incident with the doctor [stealing and usingSchedule 4 medications] made us change our protocol wheresome Schedule 4s are treated differently …Access/Security[137] At a number of sites, managers expressed concerns about the location oftheir Schedule 8 and Schedule 4 cupboards that were either relativelyisolated, making observation of staff access difficult, or situated wherepublic access was possible. Particular arrangements for storingscheduled drugs depended on the physical layout and structural limitationsof hospital areas, and on individual hospital policies.… [Schedule] 8s are locked in a cupboard but it’s in a publicthoroughfare … it’s not legal …… plenty of people can just wander in after hours or during theday and access the drugs room … there’s no security swipe onthe doors, anyone could go in …… there are two doors into the ICU [Intensive Care Unit] and ifall the nurses have their backs to the doors then anyone cancome in and grab stuff and disappear down the fire escape …[138] Schedule 8 cupboard access required the attendance of two nurses. Intheatres it was not uncommon for only one person, either a registerednurse or anaesthetic technician, to obtain Schedule 8 drugs requested bythe anaesthetist.… [the anaesthetist] asks through me and I [anaesthetictechnician] ask the nurse … the nurse gets the drugs …[139] Only one nurse was required to dispense Schedule 4 drugs from a storagefacility.[140] In theatres both Schedule 8 and Schedule 4 drugs were sometimes placedon top of the anaesthetic trolley for the anaesthetist to access. Theatreand resuscitation trolleys were not always lockable units, and those thatwere, were not always locked. In some instances, it appeared that thetrolley was left unattended and unsecured for a period of time.[141] Anaesthetists may order (verbally or in writing) scheduled drugs on anindividual patient basis. These drugs may be issued immediately prior toeach separate procedure, or in multiples according to a procedures list fora theatre session, or in large doses.… instead of getting five or six ampoules one at a time, they’llget one big multi-dose vial … it saves times … it’s laziness …[142] The specific nature of emergency departments meant Schedule 4 drugsmay be stored on open shelves for ease of access. Schedule 8 drugs35