Implementing a Revised Controlled Medication Protocol

Prescription drug abuse (PDA) in Utah continues to be at an epidemic level, which has many widespread ramifications, including a huge financial burden placed on the United States economy, and the healthcare system as a whole (Trust for America's Health, 2013). Healthcare providers play an important role in the efforts to reduce prescription drug abuse in Utah. While the majority of outpatient clinics in Utah have some sort of Controlled Medication Protocol (CMP), they are typically outdated and not consistently followed due to the various barriers that hinder provider's efforts in monitoring of patients taking controlled medications (Utah Pharmaceutical Drug Abuse Report, 2012). This project was focused on changing the standard of practice by provider and patient education. One of the main goals of this project was initially to develop a revised Controlled Medication Protocol to be implemented within an outpatient psychiatric clinic. Although this was not possible due to administrative decision and ultimate desire to instead implement a standardized Controlled Medication Protocol and patient agreement (CMA) in every outpatient clinic within this organization. The implementation process for this project included ongoing communication with content expert (Carolyn Tometich, PMHNP-BC, Operations Manager for Behavioral Health) and stakeholders; completing an extensive review of current literature and review of best practice guidelines for prescribing controlled medications (and patient monitoring) in Utah. A revised CMP and CMA was written and submitted to content expert, DNP project chair (Beverly Patchell, PhD, PMHCNS), and then to stakeholders, for implementation as soon as the approval process is complete, which is unfortunately not within the timeline of this project. A provider education presentation was given during an outpatient psychiatric meeting for psychiatric providers at an outpatient psychiatry clinic. A written survey was given to providers immediately before and after the presentation for voluntary completion in order to gain insight into provider knowledge base, perceptions and perceived barriers regarding controlled medication prescribing and monitoring practices. A final goal of this project was the completion of a patient education fact sheet on the safe use, storage, and disposal of controlled medications, and was submitted for future publication within the identified stakeholder's quarterly patient healthcare magazine, although acceptance of the article was not a formal part of this project.