In 2012 the CQC reported non-compliance of this standard in 14% of hospitals, 20% of nursing homes and 16% of residential homes.
One study reported that drug trolleys were left open and unattended 14 times a day, each episode averaging 3 minutes.
All healthcare staff know that medication cupboards should be secure but this can be difficult to achieve whilst providing optimal and timely care. The Health and Social Care Act (2008), the Duthie Report (1988) and the Safe, Secure Handling of Medicines Guidance (2005) of the Royal Pharmaceutical Society have enshrined this in best practice and law with each institution appointing a legally accountable officer.
The costs of investigating drug loss, theft or tampering may reach over £500,000 as at Stepping Hill after a nurse was found tampering with insulin, where sadly in addition to patient deaths, an innocent but accountable nurse was initially wrongly incarcerated. Worryingly, in a 'stealth' study, unauthorised persons were able to clandestinely tamper with medication in the NHS without being detected on 3 out of 5 attempts.
Drug theft is common; in a survey of hospital security personnel, 71% stated that the frequency is increasing year on year, the costs and trauma of investigating and dealing with this high.
Following a successful Eastern Academic Health Science Network (EAHSN) study of efficacy, cost-effectiveness and implementation in the NHS, the DruGuardian device has been manufactured.
The unit is self contained and has a very longlife rechargeable battery (months), and is installed in a drug enclosure.
It has a light sensor activated when the door is opened, a motion detector to determine the presence or absence of a person and an alarm that is activated when the trolley is left unattended alerting staff to re-attend.
When nurses perform their job correctly the device remains silent. Leaving the trolley open and unattended for >40 seconds (a time which can be set by the hospital) a crescendo alarm (initially quiet but becoming louder with non-attendance) is activated and the nurse is encouraged to correctly attend the trolley or secure the cupboard closed.
Behaviour is modified subconsciously by one of the most powerful psychological techniques known, Operant Conditioning.
Additionally, a camera records all attendances onto a secure SD card. This is predominantly a deterrent to theft and tampering and importantly acts to protect the legally accountable nurse entrusted with the keys.
The EAHSN study showed the DruGuardian improved CQC guideline compliance with a 20X improvement in practice and only minimal or no staff training required.
Data proving compliance with CQC guidance and UK law can be downloaded from an SD card and provided.
The DruGuardian provides a managed solution to drug theft and tampering, seemlessly modifying behaviour and protecting patients and accountable staff.
By adopting this innovation, the institution saves money and is helped to comply with UK law and CQC guidelines.