Hospitals Put Native Americans At Opioid Risk, Audit Says

The survey by the U.S. Department of Health and Human Services’ Office of Inspector General will not attract conclusions about real mistreatment or overdoses. Nonetheless it said all five Indian Health Service private hospitals that were examined got patients who were given opioids in quantities exceeding federal recommendations. Carla Lewis, one of the auditors.

The overdose epidemic that has wiped out more people than some other medication epidemic in U.S. Native Americans and Alaska Natives had the second-highest rate of opioid overdose out of most U.S. 2017, according to the federal Centers for Disease Control and Prevention. The report made greater than a dozen suggestions to the Indian Health Service to raised track patients’ health records and pain management, ensure opioids are stored under tighter security and update its IT systems.

The agency decided on every point and said changes are coming. Auditors considered the quantity of opioids each hospital dispensed and the percentage increase over 3 years when deciding those to review. They viewed 30 patient records at each hospital, frequented the facilities, and interviewed personnel. The auditors found that the hospitals strayed from recommendations in the Indian Health Manual in researching treatment for patients and their factors behind pain every 90 days.

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Patients also must signal a written consent form and an agreement to treat chronic pain with opioids so they know the risks, and benefits, as well as the necessity for medication screenings. A lot more than 100 patient records didn’t include proof informed consent, and dozens did not have evidence that providers properly informed patients. The Centers for Disease Control recommends that patients be recommended no more than 90 morphine milligram equivalents per day, a measure used to compare an opioid dose with morphine.

The audit found that each hospital fulfilled or exceeded that amount at times. At the Shiprock hospital, the daily dosage was more than four times as high. The Indian Health Service said all of its facilities now submit that data therefore the agency’s top command can track it. -More than two dozen records showed no proof patients were screened for drugs with urine tests when they began opioid treatment and periodically after. Providers didn’t have an alert system to learn when patients were due for the urine testing. The Phoenix hospital has since applied one.

-Pharmacists are supposed to review patients’ files before filling up prescriptions from another company, but that had not been done at four of the private hospitals. In a single case, Fort Yates loaded a prescription from another provider despite the medical center discontinuing treatment because the individual violated a pain-management agreement. The Indian Health Service said it could concern a directive in December for prescribers to monitor that information.