Recognizing Impairment in the Workplace

About this course

Impairment in the workplace is a common problem in healthcare and it is estimated that 10% of healthcare providers will experience impairment during their career. However, only two out of three healthcare providers will be reported for impairment. This happens for several reasons and poses significant risks to the healthcare provider, patients that they care for, and the institution that they work for. To reduce the risks associated with alcohol and substance use, the healthcare provider must be able to identify it, recognize the symptoms, have knowledge of common laws, know how to report the impairment, and understand the various evaluations and treatments.

Learning objectives

• Define alcohol and substance addiction
• Describe behaviors and risk factors of impairment in the workplace
• Analyze barriers to early identification of impaired healthcare providers
• Understand regulatory mandates that govern discipline and treatment of impaired nurses in Florida
• Summarize the essential steps to report or refer a nurse who may be impaired
• Outline the treatments available to healthcare providers who ae impaired in the workplace

Course outline

18 sections · finish in any order across devices

1. 1

   Introduction

   Impairment of the healthcare provider is a common problem in healthcare. It is estimated that approximately 10-15% of healthcare providers will experience some form of impairment while working. Impairment occurs when a healthcare provider is unable to provide competent and safe patient care because

   4 min

2. 2

   State and Federal Rules and Regulations

   Virtually all states have rules and regulations regarding the use of drugs and alcohol as the basis for disciplinary actions, especially as it relates to diversion of drugs from patients. These states also require reporting of healthcare providers who are suspected of impairment; however, the rules

   4 min

3. 3

   464.018 Disciplinary Actions

   (h) Unprofessional conduct, which shall include, but not be limited to, any departure from, or the failure to conform to, the minimal standards of acceptable and prevailing nursing practice, in which case actual injury need not be established.

   9 min

4. 4

   Genetic Factors

   Alcohol and substance use are a significant problem in the healthcare profession. It is thought that as much as 15% of all healthcare providers are impaired or recovering from alcohol or drug use. Diseases related to alcohol and drugs are one of the leading causes of preventable disability and death

   5 min

5. 5

   Signs and Symptoms of Impairment

   Dire consequences are associated with healthcare provider impairment. Often the impairment goes unreported or untreated because alcohol and substance users often do not admit they have a problem, and when they do, they will often self-diagnose and self-treat without seeking help from qualified profe

   4 min

6. 6

   Steps to Reporting Impaired Peers

   Unfortunately, sometimes it may be easier to pass the problem on to someone else. It is crucial not to ignore signs or symptoms of impairment. It is inappropriate to transfer an impaired healthcare worker or threaten termination. Passing the problem on to another department or institution is not an

   4 min

7. 7

   Diagnosis of Alcohol and Substance Abuse Disorder

   Substance use disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the standard classification of mental disorders used by mental health professionals in the United States. The criteria for substance use disorder is divided into three cate

   4 min

8. 8

   Laboratory Testing to Confirm the Diagnosis

   Diagnosis of an alcohol problem can be made in the outpatient department by using Cut down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire which includes the following:

   4 min

9. 9

   Evaluation and Treatment

   Often, the evaluation and treatment of a healthcare provider with alcohol or substance addiction is challenging. Typical treatment occurs over months to years and includes follow-up care and monitoring, sometimes by legal entities. The most important predictor of successful treatment is when a healt

   4 min

10. 10

    Treatment Techniques of Alcohol and Substance Abuse

    It is challenging to treat any healthcare provider for alcohol or substance use disorder, and it is more challenging if the treatment is under duress. Treatment usually involves the following steps:

    4 min

11. 11

    Florida Intervention Project for Nurses

    In Florida, nurses have the option of the Intervention Project for Nurses. This is a statutorily approved evaluation and treatment program approved for impaired nurses. Intervention Project for Nurses consultants are designated via contract to initiate interventions, recommend evaluations, and refer

    4 min

12. 12

    Institutional Programs

    An employer may mandate a healthcare provider to obtain treatment for impairment or face reporting and termination. Some employers offer addiction assistance programs to help with alcohol or drug problems. Programs often include health promotion, education, referral to treatment centers, treatment,

    4 min

13. 13

    Prognosis

    The prognosis of alcohol and substance abuse depends on early versus late diagnosis, motivation of the healthcare provider with the identified impairment, follow-up treatments, and the success of cognitive behavior therapy. Healthcare providers who are motivated to maintain their career and healthca

    4 min

14. 14

    Example of Reporting Requirements in Florida

    Each state has different requirements for reporting of an impaired peer. If a healthcare provider believes a peer has an alcohol or drug problem, it is essential that they report it to their supervisor and the appropriate state-mandated authorities.

    4 min

15. 15

    Fitness to Practice

    The Intervention Project will evaluate and access a nurse’s ability to safely practice including stability, recovery, support systems, and specific job skills including problem-solving, judgment, cognitive function, and coping skills. The Intervention Project makes several requirements of the nurse

    4 min

16. 16

    Conclusion

    Healthcare providers must be able to recognize the signs and symptoms of impairment. They should also be able to evaluate their colleague’s job performance and consider the possibility of substance or alcohol use when consistent deficient performance is observed. They also must be able to identify t

    4 min

17. 17

    Recognizing Impairment in the Workplace Posttest

    The Florida Nurse Practice Act is an example of a typical state law regarding the use of controlled substances and the necessary reporting.

    4 min

18. 18

    Recognizing Impairment in the Workplace Posttest Answers

    It is estimated that approximately 10-15% of healthcare providers will experience some form of impairment while working. Impairment occurs when a healthcare provider is unable to provide competent and safe patient care because of the use of prescription or nonprescription drugs, alcohol, or mind-alt

    7 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

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