Saturday, December 29, 2012

Security considerations for Healthcare Pharmacies: Access Control

This is going to be a basic primer for healthcare professionals on safety and security considerations related to pharmaceuticals and pharmacies located in healthcare facilities.

Pharmacies located in healthcare facilities are very different from retail pharmacies one may be accustomed to seeing outside of the healthcare facility. For starters typically pharmacies in a hospital are an internal department that the public will have little to no interaction with. There is typically no retail aspect and as such any security risks related to retail establishments and the handling of cash will normally not apply here.

Some hospitals will have both a public retail pharmacy (possibly merged with a gift shop) in addition to the facilities pharmacy department however the security concerns addressed here will not apply to a retail establishment.

One thing to please remember as we cover this is that the pharmacy is not the only source of risk with relation to prescription medications and controlled narcotics. In a hospital the pharmacy acts as the central hub of a large and sometimes complicated distribution chain for medication so as such there are security risks at every link of that distribution chain. Now like all pharmacies the process starts with a pharmacist receiving a written order from a licensed physician the drugs may be for a specific patient or it may be an order for a nursing units, medicine cart, cabinet, night cupboard or automated dispenser.

Another thing to keep in mind is that Pharmacies are a vital area of high risk due to the requirement to follow stringent policies and laws related to how medications orders are processed and dispensed. Depending on the particulars of the facility or the substances being dispensed pharmaceutical activity can be monitored and regulated by a wide variety of external agencies such as the Royal Canadian Mounted Police, Canada Border Services Agency, Canadian Food Inspection Agency, Canadian National Institute of Health and Accreditation Canada. All of this leads to a higher need for enhanced security measures and diligent efforts to deter incidents from occurring by all employees of the healthcare facility but especially of physicians, front line nurses, the security department and the pharmacy staff.

Access Control:

Access Control should be the principal effort of every physical security plan.

For pharmacies there should be minimal entry ways and those entry points should be secured by an electronic access system. It could be as simple as a keyed or magnetic lock depending on the risk level of the department or ideally it should employ a layered access system of for example a swipe access reader couple with a key pad requiring a unique PIN number to enter the department. CCTV systems set up to allow a good overview of the entire department. The compounding area (The part of the pharamcy where drugs are store and prepared) should also be keyed and possibly have an electronic lock and should only be accessible with the staff pharamcist present.

That being said in hospitals staffing issues and emergencies tend to get the best of you therefore you should have a system in place to permit access by other staff members in case a pharmacist is off site or the incident occurs after hours. However it should also be a policy that the event is recorded and a detailed incident report is typed up explaining the reasoning behind the breach of policy. Security should also be considered to provide an escort

Pharamcies should also have trouble alarms installed that in the event of something unusual the security department receives automatic notification of the incident. There should also be silent trouble alarms at work stations in the event of a robbery attempt.

In summary a solid access control system can make the department much more secure and it can make things a hell of a lot easier for all involved and also provide detailed eyes on account of what happens. A proper Access Control system can also make the department a lot more safer and deter theft from the actual department.

In the next step we will talk about Drug Diversion and the theft of medications outside of the pharmacy department.