The Pennsylvania Nurse Peer Assistance Program ANNUAL REPORT 2014

Transcription

1 The Pennsylvania Nurse Peer Assistance Program ANNUAL REPORT 2014 Presented by: Kathie Simpson, Executive Director of P.N.A.P. Prepared by: Traci Holler, Executive Assistant 1

2 P.N.A.P. Mission To identify, intervene upon, advocate, monitor and provide support, Help and Hope to the Nurse or Nursing Student experiencing Addiction, Alcoholism and other Mental Health Disorders. Through Peer Assistance the licensee will satisfactorily demonstrate to the Board of Nursing that he/she has made significant progress in personal rehabilitation and SHOULD NOT BE EXPECTED TO CREATE A RISK OF HARM AND SAFETY OF PATIENTS OR THE PUBLIC. 2

3 P.N.A.P. Open Files 1093 open current as of December 31, Are being monitored under a P.N.A.P Contract 137 Are being confidentially monitored by P.N.A.P. only 52 Have requested monitoring for a substance use disorder 85 Have suspended licenses and are documenting for reinstatement 829 Are being dually monitored by PHMP and PNAP 639 Are being monitored under a Voluntary Recovery Program Consent Order 184 Are being monitored under a Disciplinary Monitoring Unit Consent Order 6 Have licenses that are suspended by PAR pending final order 127 additional referrals are pending 66 Have been referred for an evaluation and results are pending 61 Referrals have been received and we are awaiting their calls 3

4 P.N.A.P. Referrals and Outcomes Number of Nurses who May 17, Total since inception Contacted or were referred to P.N.A.P Failed to contact P.N.A.P. when referred by the PHMP Called only to inquire about the program Contacted P.N.A.P and subsequently refused participation Only 8.9% of nurses referred to P.N.A.P. have refused to cooperate with evaluation requirements in 2014, and only 9.2% of refused since inception. 4

5 P.N.A.P. Referrals and Outcomes May 17, Number of Nurses who 2014 Total since inception Were diagnosed with a substance use disorder and refused to enter treatment Fully cooperated, were evaluated, and did not meet criteria for a substance use disorder Entered into a monitoring contract with PNAP % of those referred and evaluated did not meet diagnostic criteria for monitoring. 5

6 P.N.A.P. Referrals and Outcomes Of the 966 nurses being monitored under contract, 428 or 44% have criminal convictions or criminal charges that are pending 51% of those charges were for DUI and not related to diversion or drug use CONVICTIONS 41 Felonies under the Drug Act 12 Felonies Other 82 Misdemeanors under the Drug Act 11 Misdemeanors under the Pharmacy Act 27 Misdemeanors Other 217 DUI only PENDING CRIMINAL CHARGES 38 have criminal charges pending 6

7 P.N.A.P. Relapses May 17, Number of Nurses who 2014 Total since inception Have entered into a monitoring contract with P.N.A.P. Have been monitored by P.N.A.P. under contract at any point during the year Have relapsed while under contract Relapse is defined as the intentional use of a prohibited substance. 11 of these were due to a client ingesting a prohibited substance. 6 ate products containing poppy seeds that produced positive results for morphine, 5 used products containing alcohol (Nyquil) that produced positive results for alcohol and peth tests were negative. The negative peth test supported a limited use rather than ingestion for intoxication. This represents an 8.5% RELAPSE RATE IN 2014 AND A 7.4% AVERAGE ANNUAL RELAPSE RATE OVER THREE YEARS The NATIONAL INSTITUTE OF DRUG ADDICTION reports a 40-60% relapse rate among the general population in 7 treatment for drug addiction

8 P.N.A.P. Relapses 52 of 158 nurses who had experienced a relapse in 2014 had returned to practice. the average time between return to practice and relapse was 10 months. 24 of the 52 experienced a relapse while their controlled substance restriction was in place; 11 had relapsed between 6 and 26 months of return to practice and had not requested their controlled substance restriction be lifted 28 of the 52 after their controlled substances restriction was lifted; the average time between the lifting of controlled substance restriction and relapse was 13.8 months 8

9 P.N.A.P. Relapses 1 of the 29 who had returned to practice in Pennsylvania and experienced a relapse had diverted or attempted to divert from the workplace 1 RN working on an inpatient rehabilitation unit with the controlled substance restriction lifted, called in a fraudulent script for Tramadol from her workplace Another RN who is primarily monitored in NJ who also holds a PA license, diverted fentanyl. 9

10 P.N.A.P. Violations Number of Nurses who May 17, violated Violated while under contract, were remanded to the legal division by the PHMP and refused to continue monitoring with P.N.A.P Total since inception 548 Violated while under contract, were remanded to the legal division by the PHMP and continued monitoring with P.N.A.P Total violations In 2014, of 1848 clients monitored, 158 relapsed. An additional 131 violated for reasons other than relapse. 15.6% violation rate and 84.4% compliance rate in 2014 Over the past three years, an average of 7.4% of monitored clients violated by relapse and 4.3% violated for missing ROBS, criminal convictions, and other infractions for a total of 11.7% violation rate or a 88.3% compliance rate overall 10

11 P.N.A.P. Referrals and Outcomes May 17, Number of Nurses who 2014 Total since inception Have passed away 4 prior to contact with P.N.A.P.; 1 prior to completion of intake (unknown); 1 prior to receipt of evaluation (suicide); 4 while under contract (2 auto accidents, 1 suicide, 1 head trauma accident) Were ineligible for P.N.A.P. and PHMP to monitor due to distribution, sexual boundary violations, and criminal convictions Were ineligible for P.N.A.P. and PHMP due to patient harm

12 P.N.A.P. Referrals and Outcomes May 17, Number of Nurses who 2014 Total since inception Had their employers withdraw the complaint, investigations unfounded Surrendered license rather than participate in monitoring Withdrew their application for licensure due to more stringent monitoring requirements in Pennsylvania

13 P.N.A.P. Referrals and Outcomes May 17, Number of Nurses who 2014 Total since inception Enrolled in P.N.A.P. to document for reinstatement of nursing license, but did not want to or could not fulfill the requirements necessary to provide verifiable, documented recovery for reinstatement Successfully completed their contracts*

14 P.N.A.P. Recidivism May 17, Number of Nurses who 2014 Total since inception Successfully completed their contracts Were referred back to PNAP after having successfully completed their contract Rate of recidivism 3.4% 1.8% 7.6% 4.4% Results from studies on rates of recidivism for those involved in monitoring programs are difficult to find, but in order to provide a frame of reference for the success of PNAP in preventing recidivism, consider the following: That nearly 70% of drug abusing offenders return to prison within three years of their release (Langan & Levin, 2002). And, effectiveness studies have shown that inmates who participate in residential treatment programs while incarcerated have 9 to 18 percent lower recidivism rates and 15 to 35 percent lower drug relapse rates than their counterparts who receive no treatment in prison. (Corrections & Mental Health National Institute of Corrections, 2012) 14

15 P.N.A.P. Getting Nurses Back to Work Number with an active license who Are being monitored under contract Are being monitored and have been permitted to return to the practice of nursing Are being monitored and have returned to the practice of nursing Have successfully completed monitoring and are assumed to be working in their fields in ~ 71.5% 434 ~ 49%

16 P.N.A.P. Getting Nurses Back to Work In the 2014 calendar year 844 nurses with an active license who are being monitored under contract or who have successfully completed with P.N.A.P. are employed. 196 additional have been permitted to return to practice and are seeking employment. 49% (434 out of 881) of our monitored and actively licensed nurses are employed. and an additional 22% (196 out of 881) have received permission to return to practice and are seeking employment. The remaining 24% (251 out 881) have not received permission to return to practice. 16

17 P.N.A.P. Getting Nurses Back to Work 694 employed as RNs with average salary of $69, employed as LPNs with average salary of $35, employed as CRNAs with average salary of $140, employed as CRNPs with average salary $90, total employed Approximate 2014 earnings totaling $57,555, which are taxable by the Commonwealth of Pennsylvania Due to P.N.A.P. referrals to attorneys for those criminally charged, advocacy at hearings, and ability to negotiate longer probationary monitoring, we are able to contribute to a decrease in license suspensions. Nurses are able to return to practice and contribute to the tax rolls in the Commonwealth. 17

18 Advocacy by P.N.A.P. Case Managers May 17, Total since inception Testimony provided to PA Board of Nursing in Reinstatement and Mitigation hearings Hearings avoided by working out an agreement with the Board Testimony provided in criminal or unemployment proceedings Total advocacy by P.N.A.P Case Managers in criminal and disciplinary matters

19 Education by P.N.A.P. Case Managers May 17, Total since inception Continuing education presentations to health care facilities, nursing schools, and nursing organizations Marketing/Performance improvement presentations to treatment facilities Case managers attendance at Health Care Professionals Groups with PNAP enrollees

20 Referrals by Discipline RN % LPN % CRNA % CRNP % RNCS 2 <1% RN STUDENT % LPN STUDENT 28 <1% RN GRADUATE % LPN GRADUATE 36 <1% RN APPLICANT % LPN APPLICANT 14 <1% DIETICIAN 3 <1% UNKNOWN % TOTAL

21 Enrollment by Age/Gender 77.4% Female 22.6% Male Average age is

22 P.N.A.P. Contracts Are legally binding between the licensee, employer, therapist, physician, and P.N.A.P. Form the basis for the Board s action if breached by the nurse Are often incorporated into sentencing by Judges in the Commonwealth of PA Are generally in effect for a three year term but may be modified if Board action or legal requirements mandate additional monitoring by P.N.A.P. in coordination with the PHMP 22

23 P.N.A.P. Monitoring Motivates licensees to stay clean and sober by encouraging accountability Mandates total abstinence Monitors adherence to treatment recommendations Requires verified 12 step meeting attendance, including Nurse Assist meeting attendance Provides the basis for documenting abstinence with random, observed body fluid screening, ethylglucuronide testing, peth testing and hair analysis testing for drugs and alcohol 23

24 P.N.A.P. Monitoring Supports restoring licensees to healthy, safe, and competent practitioners Monitors licensees return to practice through required quarterly work evaluations Promotes employer awareness in order to encourage hiring of recovering nurses Ultimately protects the public from unsafe practitioners HAS DEMONSTRATED SUCCESS! 24

25 WE ARE TALKING ABOUT A LIFE AND DEATH DISEASE CALLED ADDICTION. IT IS A DISEASE THAT IS PROGRESSIVE AND FATAL IF LEFT UNTREATED. THIS DISEASE AFFECTS 1 in 5 NURSES AND 1 in 4 NURSING STUDENTS. HELP IS AVAILABLE.IF YOU OR A LOVED ONE IS SUFFERING CALL P.N.A.P. AT or ksimpson@pnap.org 25