Wettlaufer inquiry hears about safe medicine practices

The storage and administrating of medicine is the focusof Thursday's testimony at the Long-Term Care Inquiry in Toronto.

Julie Greenall, director of projects and education at theInstitute for Safe Medication Practices Canada, is testifying about best practiceswith inquiry lawyers.

The public inquiry is looking into how ElizabethWettlaufer, an Ontario nurse, kept up a near decade-long run of murdering patients undetected.

Preventing and detecting intentional harm

The inquiry heard about how diversion of medications has increased recently in response to the national opioid crisis. Greenall testified that there needs to be consideration for diversion of medications beyond opioids.

"That really has been our focus, because they are the medications most commonly diverted," said Greenall.

"But I think the recognition that there may be diversion of other medications for various reasons is something that people really do need to start to think about."

Greenallagreed with the inquiry that the Wettlaufer murders were cases of diversion of insulin for the purpose for which it was not prescribed.

Pharmacy technicians can also play a role in helping with medication management in long-term care.Pharmacy technicians are independently regulated health care providerswho are college trained and specialize in medication management systems.

"I think pharmacy technicians could provide a very important supportive role for nurses in long-term care," said Greenall.

"There are multiple ways that they could help, but I think specifically, related to all of the kind of inventory management activities, they could just take that over."

Greenallsays pharmacy technicians have a very strong knowledge of medications and medication systems.

"I think theyalso would really provide that oversight role; so they would really be aware of 'what is in the fridge?When were medications ordered? Why do we suddenly haveto reorder this medication when we just got it?'"

Implementing a positive safety culture

Greenalldiscussed the idea of developing a positive safety culture at long-term care facilities with the aim of reducing the likelihood of untoward incidents.

"It's really a whole philosophy for how an organization operates," she said. "It has to be more than, 'our policy is that we're providing safe care,' it's 'what are the steps that we're taking to insure that?'"

In a positive safety culture, Greenallsays frontline staff would be involved in reviewing incidents, such as falls ormedication incidents,and then discuss solutions to reduce the likelihood of them reoccurring.

Health-care killers aren't as rare as peoplethink:expert

Beatrice Yorker, a professor of nursing and criminal justice at California State University, Los Angeles, testifiedWednesday at the inquiry.

She has studied at least 90 cases worldwide that date back to the 1990s, each one involving health-care professionals who became serial killers targeting their patients.

"Nobody has given as much detail as she has," Yorker said. "When it comes to premeditation, (Wettlaufer) has given us more insight than any other health-care killer."

Wettlaufer confessed in 2016 to killing eight of her patients and trying to kill six more all with injections of lethal amounts of insulin.

The 51-year-old former registered nurse is currently serving a life sentence for her crimes at the Grand Valley Institute for Women in Kitchener, Ont.

The inquiry is holding three days of hearings in Toronto before returning tothe courthouse in St. Thomas, Ont. to wrap up this phase of its work.