5 Best Practices for Health Care Employment Drug & Alcohol Screening

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Although employment screening in the health care industry is highly regulated, drug and alcohol testing is often not required by law.

Drug and alcohol screening is vital because an individual with patient contact that abuses drugs or alcohol may put employee and patient safety at risk and increase the frequency of negligence or malpractice claims.

Additionally, health care workers often have access to powerful prescription drugs, increasing the risk of on-site drug theft and abuse.

The HireRight Health Care Spotlight, based on HireRight’s 2011 Employment Screening Benchmarking Report, illustrates how health care organizations approach drug and alcohol testing.

Health care drug testing methods

Source: HireRight Health Care Spotlight

First, 64 percent of employers said they test for drugs and alcohol, exposing a gap of 36 percent of organizations who have unscreened workers. Second, the most common type of drug and alcohol tests used by respondents is urine (63%), followed by blood (6%), breath alcohol (5%), saliva (3%), and hair (2%).

Urine is the most common method of testing in all industries and health care companies likely use it because of the expanded drug test panels that other tests such as saliva and hair lack. Urine testing is also accurate and has been in use longer than other types of drug and alcohol testing.

Common reasons a health care organization may not perform drug/alcohol screening is the complexity of properly administering the tests, concerns about the individual’s legal rights and the time it takes to obtain results when competing for available talent.

Additionally, many employers are uncomfortable administering a urine test and if the test is not performed properly, a worker may try to adulterate the urine analysis using other substances or false samples. Some substances may become undetectable in the urine after 48 hours, and this leaves ample time for substance users to delay testing and avoid detection.

But the risks to an organization of employing someone that is actively abusing drug or alcohol are substantial and that’s why organizations are evaluating their testing programs.

5 Best Practices for Health Care Employment Drug/Alcohol Screening
How can health care employers improve their drug and alcohol screening programs? Below you’ll find five best practices for creating stronger drug and alcohol screening policies.

1. Perform Drug and Alcohol Testing on all Employees
Protecting the safety of patients and staff requires more than conducting traditional criminal background checks. While an employee may not have a criminal record or health care sanction, if they abuse drugs, they can still pose significant safety risks. Generally, individuals that abuse drugs are less productive and are more prone to costly workers’ compensation claims.

To protect patient and staff safety, preserve productivity, and defend your brand, health care organizations should include a comprehensive drug and alcohol testing policy as part of their overall screening program. Employers that commit to drug and alcohol testing for their entire workforce are better able to mitigate the risks of individuals that abuse drugs.

2. Partner with a Screening Provider to Develop or Update a Drug and Alcohol Testing Policy
Health care organizations who work with a trusted screening provider can quickly get their drug and alcohol screening programs up-to-date. Expert providers can help design a program that works in compliance with state and federal laws concerning medical marijuana, discrimination, and privacy.

3. Tailor Testing to Your Needs
Use testing policies and methods that will increase accurate findings. For example, a policy can be drafted to require that urine testing be completed within 48 hours of notification. If a worker cannot meet that deadline, then a hair-strand test is performed instead. Hair tests can detect substances for up to 90 days and can thwart deception efforts by a worker who waits for the 48-hour window for urine detection to pass.

Other options include adding saliva or blood or breath alcohol tests. When tailoring a drug/alcohol screening program to an organization’s needs, screening managers should consider what types of medications workers can access.

For example, higher level employees with access to medications may be tested for additional types of drugs using an expanded drug panel and workers who do not have access to medications may be given a test with a different panel.

4. Run Comprehensive Tests
For organizations that use urine tests, there is a way to check for common adulterates along with the presence of drugs and alcohol. Health care employers should conduct the standard five-panel test for marijuana, cocaine, PCP, amphetamines and opiate metabolites.

For employees that have access to medications and/or distribute medications, organizations may want to use an expanded panel because many of these medications are highly addictive. Therefore, an organization should examine the types of drugs that should be tested for and build a program that identifies when each type of test is given.

For example, health care workers that have access to pharmaceuticals should be tested for barbiturates, benzodiazepines, methadone, and propoxyphene.

5. Implement Random Drug/Alcohol Testing
Because some health care workers have access to highly addictive medications, organizations are adding ongoing random drug/alcohol tests to their screening programs to protect patient and employee safety. This is especially useful to deploy for workers who are distributing medications.

Ongoing drug screening helps to mitigate many risks of a workplace incident that could lead to a claim or bad press. Having a random drug testing program in place is essential to reduce ongoing risk. Since drug free workplace programs are predicated on deterrence, without a random drug screening program, an active drug abuser need only “pass” his/her pre-employment screen to resume their drug use without “fear” of subsequent employment testing.

Are you examining your health care organization’s drug/alcohol policies and screening methods?

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HireRight is a leading provider of on-demand employment background checks, drug and health screening, and electronic Form I-9 and E-Verify solutions that help employers automate, manage and control background screening and related programs.

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