Closing the surveillance gap: Development of a technology-integrated model for nurse anesthesia student controlled...

Controlled substance (CS) diversion poses serious risks to patient safety, provider well-being, and institutional compliance, particularly in anesthesia practice where potent medications are routinely handled. Nurse anesthesia students are often entrusted with CS preparation and administration under indirect supervision but are frequently excluded from automated dispensing systems. When preceptors retrieve medications on students' behalf, transactions are recorded under the preceptor's credentials, eliminating individual accountability and rendering students invisible to surveillance systems. To address this oversight gap, a newly established nurse anesthesia program partnered with a large academic health system to design a standardized, technology-enabled oversight framework. The model will provide each student with role-based, time-limited system credentials synchronized to clinical rotation schedules, ensuring that all CS transactions-dispensing, administration, and waste-are traceable to the individual performing the task. The framework's five pillars-interprofessional collaboration, standardized policy, annual diversion prevention education, analytics-based surveillance, and clear reporting pathways-align with best-practice recommendations from the American Society of Health-System Pharmacists and standards from the Drug Enforcement Administration and The Joint Commission. Although full implementation is pending, this proactive approach exemplifies a scalable, systems-based solution that strengthens diversion prevention while serving as a pedagogical imperative. Furthermore, embedding students in the same surveillance infrastructure as licensed providers prepares them for the regulatory realities of modern healthcare and sets a new standard for safety, accountability, and professional integrity in anesthesia education. This report describes the pre-implementation phase of this quality improvement initiative, highlighting the rationale, development, and expected benefits and challenges of the framework.