Securing medications

Review the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) standards and requirements for medication security.

Employee theft and fraud: bigger than ever and getting worse

Fraud examiners and investigators say that employee theft is out of control, citing recent U.S. Chamber of Commerce figures that employees steal approximately $400 billion from businesses each year and an Ernst & Young survey showing that nearly 90% of organizations countrywide experienced some type of fraud in the 12 months prior to the survey. An additional undetermined amount is being reported lost because of external fraud committed by customers, vendors, and others having contact with a company or institution. Fraud experts interviewed for this report note that all sectors are targets--including retailers, hospitals and healthcare, the hotel industry, schools, and college campuses. In this report, we'll present the how's and whys of this development and also describe what one medical center is doing to stop thefts of medical equipment and computers.

How can you protect yourself from employee dishonesty?

BACKGROUND

Forty percent of dental offices have been or will be embezzled by an employee.

OVERVIEW

As employers, dentists need to prescreen applicants diligently, as well as take strong, proactive roles in the monitoring of all business aspects of their practices.

PRACTICE IMPLICATIONS

To make their offices embezzlement-proof, dentists need to take responsibility for both implementing and monitoring strict accounting and banking procedures.

Effectiveness of crime prevention through environmental design (CPTED) in reducing robberies

OBJECTIVE

The objective of this study was to determine the effectiveness of the Crime Prevention Through Environmental Design (CPTED) approach in reducing robberies.

METHODS

CPTED evaluations were obtained through a comprehensive search mechanism. Two sets of inclusion criteria were used: 16 primary studies evaluated a CPTED program with a comparison period; 12 secondary studies presented some evidence of CPTED effects but were not required to have the same level of scientific rigor. The percentage change in pre- and post-intervention events was the outcome examined. Studies were stratified by programs implementing multiple components, a single component, and through ordinances.

MAIN RESULTS

All primary multiple-component CPTED programs experienced a percentage change in robberies ranging from -84% to -30%. Single-component program effects ranged from -83% to +91%, and ordinances ranged from -65% to +130%. Secondary studies reported robbery changes ranging between -92% and +7.6%. Robbery reductions were larger for interventions comprising basic store design, cash control, and training components compared to those including equipment systems. No associations were found between robbery decreases and either the follow-up period or the number of program components. Studies examining nonfatal injuries found a median pre-post change of -61%; those examining homicides found changes ranging from 0% to +11%.

CONCLUSIONS

The broad nature of the CPTED approach allows its adaptation to any setting, and results indicate that it is an effective approach to reducing robbery. However, most interventions were not evaluated independently of other factors contributing to robbery risk. More research is needed on individual components and effects in various business settings.

Treatment of covert food stealing in an individual with Prader-Willi syndrome

Covert food stealing is common among individuals with Prader-Willi syndrome. We found that verbal reprimands, delivered contingent upon eating prohibited foods, were sufficient to decrease the food stealing of a girl with Prader-Willi syndrome. Warning stimuli were then used to help her discriminate between permitted and prohibited foods during sessions in which food stealing was not directly observed. This procedure resulted in decreases in food stealing from containers labeled with the warning stimuli.

Interactions between electronic article surveillance systems and implantable cardioverter-defibrillators

BACKGROUND

In patients with implantable cardioverter-defibrillators (ICDs). inappropriate shocks have been reported with exposure to electronic article surveillance systems. The risk to patients with ICDs of walking through or lingering near surveillance systems requires further investigation.

METHODS AND RESULTS

We evaluated the response in ICD function in 170 subjects during a 10- to 15-second midgate walk-through of and during extreme (2 minutes within 6 in of the gate) exposure to 3 common article surveillance systems. Complete testing was done in 169 subjects. During a 10- to 15-second (very slow) walk-through of the 3 surveillance systems, no interactions were observed that would negatively affect ICD function. During extreme exposure (169 subjects) and during extreme exposure and pacing via the ICD (126 subjects), interactions between the ICD and the article surveillance systems were observed in 19 subjects. In 7 subjects, this interaction was clinically relevant and would have likely (3 subjects) and possibly (4 subjects) resulted in ICD shocks. In 12 subjects, the interaction was minor.

CONCLUSIONS

It is safe for a patient with an ICD to walk through electronic article surveillance systems. Lingering in a surveillance system may result in an inappropriate ICD shock.