Hi,

 

We have developed a process whereby if the MRO confirms legitimate prescriptions for a positive screen or if the person self discloses narcotics or multiple meds, they are required to be evaluated by an occ doc to determine if there is any sign of clinical impairment, in which case the hiring process is put on hold. If there is no sign of clinical impairment, but the amount of meds is significant, e.g., greater than 20 morphine equivalents per day, a No Safety Sensitive Duty restriction is issued. HR then discusses the issue with the job applicant. If the position is not SS, then all goes well. If the position is SS, the person is encouraged to work with their prescribing provider to reduce the dose(s).

 

I have never received a note from a prescriber saying that the drugs they prescribe could be impairing their patient, even if that person is a nuclear scientist or neurosurgeon. After all, if they are prescribing the drugs they must be safe. Right?

 

We occasionally request a letter from the prescriber to confirm that the dose the person reports is accurate, i.e., when a prescription is written as prn and they receive 120 per month, but swear that they only take it at bedtime/on weekends.

 

Stay safe, Stay healthy,

Ron

 

Ron Teichman, M.D., M.P.H., FACOEM, FACP

Division Medical Director

Banner Occupational Health and Wellness

1300 N. 12th Street, Suite 610

Phoenix, AZ 85006

Ron.teichman@bannerhealth.com

 

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Hayden, Jamie R
Sent: Thursday, October 6, 2022 9:45 AM
To: mcoh-eh@mylist.net
Subject: [EXTERNAL] [MCOH-EH] Prescription Medications and Safety Risk

 

Hello,

 

When new hires complete our health assessment form, they include what medications they are taking which could include opiates and/or other drugs that could affect their ability to perform their job duties. At the time of the visit, the RN counsels the new hire on the side effects of those medications and explain the fitness for duty policy, which requires employees to present to work unimpaired and fit to perform their job.

 

Their urine drug screen tests positive and goes to the medical review officer (MRO) who verifies the new hire’s prescriptions. If the new hire is on multiple medications that could impair them, the urine drug screen result will also include a statement, “A safety risk may exist- recommend further evaluation”.

 

We were curious to know what other organizations do in these situations? Do you require these individuals to provide a note from the prescribing provider or PCP stating they are safe to perform their job duties with their prescribed medications? What happens if this comment is not included on the result from the MRO, but the employee disclosed that they take medications that could cause impairment like opioids or benzodiazepines? Do you require anything additional from these individuals to clear them to start work?

 

Thanks,

Jamie

 

Jamie Hayden RN, BSN

she/her/hers – What are personal pronouns?

Lead RN, Employee Health Services

UWHealth, UW Hospital and Clinics
700 University Bay Drive Suite 101
Madison, WI 53705

Phone: 608-263-7535
jhayden@uwhealth.org