Substance Abuse and Misuse Identification and Prevention: An Evidence-Based Protocol for CRNAs in the Workplace

Healthcare providers are susceptible to substance abuse, and anesthesia personnel are some of the most vulnerable. Substance abuse is the principal cause of professional impairment for Certified Registered Nurse Anesthetists (CRNAs), with 1 of 10 experiencing addiction to drugs or alcohol. Despite this problem, there is no standardized screening protocol for the identification of substance abuse or misuse for CRNAs. The purpose of this evidence-based protocol is to provide a standardized approach for the prevention and early identification of substance abuse and misuse in the practicing nurse anesthetist. An evidence-based protocol was created for workplace prevention of substance abuse and misuse. This article addresses the need for a protocol by including occurrences of accidents and injuries, consequences to anesthesia practice and patient care, costs, and the culture in an anesthesia group or department. Components of the protocol are formation of a committee, risk assessment, clear workplace policy, annual continuing education, annual supervisor training, drug screening of anesthesia personnel, pharmacy accountability, and access to treatment. The article describes the protocol and provides supplemental information to aid in implementation at other anesthesia departments. Substance abuse among CRNAs is a complex issue. This protocol is only an attempt to abate this problem.