DANVILLE -- Despite a security procedure that the state Department of Health calls forward-thinking, a Bloomsburg registered nurse was able to pilfer Geisinger Medical Center's narcotics dispensation system 30 times last year, police said.
Traci N. Lapaglia, 27, was charged Tuesday by Mahoning Township police and the state attorney general's office for allegedly stealing narcotics by obtaining up to four times the amount of painkillers prescribed to patients, giving the patients the appropriate amount and keeping the rest.
Medications kept in locked cabinets require an identification number and password to access, a Geisinger official said Tuesday, and activity is analyzed monthly through electronic reports.
These reports keep track of times, dates, medications removed and by whom.
Lapaglia is accused of illegally possessing drugs eight times between May and September and 22 times between May and June and failure to keep or furnish records for dispensing those drugs.
The hospital would not comment on the specific case.
John Jones, a registered pharmacist and vice president for Geisinger Health System therapeutics, said medications normally are stored on a patient care unit and kept in an automated dispensing cabinet. The cabinets are locked, and a personal identification code and password are required to enter.
A double safeguard for medicines such as controlled substances or narcotics is an additional password and code.
"Any time a nurse or health-care professional has access, all is timestamped and footprinted so we know who went into the cabinet and what drug they were accessing," Jones said. "We can see what drug is taken, what time and how often."
The pharmaceutical department, Jones said, keeps control of who has access to the separate cabinets. A health-care professional may not have access to one on a different floor.
Jones said a monthly report is then run, based on data from the cabinet that tells who accessed the cabinet, how often, what medications they took out of the machine and for what patient.
If it appears someone is taking more medications than necessary, Jones said the data acknowledges a potential alert so more reports can be analyzed. Electronic reports are available up to several years.
"It does not necessarily mean someone was doing something wrong," he said.
In the case of questionable activity in the report, Jones said an interdisciplinary team meets to decide what procedures to take. The team consists of members from different areas of the hospital, including pharmacy, nursing, security and human resources.
"The Department of Health looked at our protocol and procedures and felt it was very forward-thinking," Jones said, "as well as ahead of the curve of other institutions."
The security department, Jones said, decides when to contact external authorities -- be it the police or the Department of Health.
Thorough research is done before any decisions are made on suspension or termination, Jones said.
While nurses are primarily those administering medications, Jones said, there are other health-care providers with access to the cabinets. Pharmacists, pharmacist technicians and therapists are among them.
Scott Bitting, director for Security and Emergency Management Services at the hospital, said Geisinger has a well-defined process to conduct investigations related to medication or narcotics irregularities.
"When an investigation identifies that a crime may have occurred, we report and cooperate fully with the appropriate law-enforcement agencies," he said in a statement. "Agencies involved include the Mahoning Township Police Department and the Narcotics Diversion Division of the state attorney general's office. We have established and maintain an effective working relationship with these agencies."
n E-mail comments to gmorton@dailyitem.com.
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