Orientation Drug Testing in Workplaces

1. Orientation Drug Testing in Workplaces Department of Health National Reference Laboratory

2. National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

3. Objectives of presentation • To provide overview of the Random Drug Testing (RDT) in the Workplace • To describe protocols in Workplace RDT: • Pre-collection Activities • Specimen Collection • Screening and Confirmatory Drug Test • Relevant Documentation Requirements • Present FAQ in RDT National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

4. Components of DFWP • Advocacy, education and training • Drug Testing • Treatment and rehabilitation and referral • Monitoring and evaluation National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

5. Objectives of RDT the workplace • To promote a safe and healthy drug – free environment • To prevent drug abuse in the workplace • To provide assistance and medical intervention in case of positive drug test results • To provide education , advocacy against use of drugs • To acquire prevalence data on use of drugs for policy formulations National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

6. RDT requirements: • RDT for officials and employees shall be conducted in accordance with agency work rules , guidelines and regulation • Shall conform with the RDT procedures prescribed by DOH. • Shall consist both screening and confirmatory tests conducted by a DOH accredited DTL • Employee must be informed of the test results National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

7. RDT requirements: • When the result is confirmed positive, the Drug Free Workplace Committee shall evaluate and determine the level of care and administrative intervention • All cost of drug testing shall be borne by the agency • All information must be kept confidential National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

8. General Flow of Drug Testing National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

9. On site Selection and Randomization • Use of computer with MS Excel or scientific calculator • Request for list of employees • In the presence of selection committee , selection thru randomization procedure • Formula: = RAND()*(P-1)+1” where P = population If using calculator: key in the population, shift RAN, then equal Note: Get extra random number for possible absent employee National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

10. Randomization… cont • List down the randomized number with corresponding name of employee • Request the WP- Drug Testing committee to locate the selected employee for drug testing and come to testing site National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

11. Flow of drug of abuse testing

12. General flow (cont) Require proper specimen transport & handling

13. Why is there a need to have a laborious specimen collection for DT? Because of the high incidence of “beating the drug test” thru tampering of specimen National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

14. Forms of Tampering Specimen • Dilution • Adulteration • Substitution National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

15. Authorized specimen collector (ASC) • Designated, authorized to collect specimen for drug abuse testing • With training in specimen collection • Collection protocol • Chain of custody and record keeping • Recognition of invalid specimen National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

16. Functions of ASC • Perform proper collection • Documents all steps of collection thru CCF • Inspect integrity of urine • Verifies the identity of the client • Ensures security of specimen at collection site National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

17. Type of collection site for workplace RDT Remote collection • Specimens are collected at a temporary facility located at a remote site • For DepEd within the ff : • Central office • Regional offices • Division • School premises National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

18. COLLECTION SITE • A toilet / stall providing privacy for specimen collection • Hand washing facility outside of toilet National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

19. Urine Specimen: specimen for testing • 60 ml urine specimen • Easy , economical • Established specimen validity tests National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

20. 60 ml urine specimen bottle • Polyethylene • Screw capped • Wide mouth • With labels National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

21. Specimen Collection for Urine Begin Seal Specimen Verify Donor’s ID Complete CCF Fill-up of DT Forms Ready for Analysis End Collect Urine

22. Preliminary procedures prior to collection • Verify identity of donor • Explain basic collection procedure • Answer questions regarding the procedure • Secure information re current medications , alcohol, other medical information National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

23. Donor identification and verification • Valid photo ID ( driver’s license, employee’s ID, passport etc) • Or identification by authorized agency representative National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

24. Steps in collection either give or allow the donor to select the specimen bottle the bottle is opened in full view of the donor label container legibly National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

25. Label container legibly National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

26. Put coloring agent when applicable National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

27. Steps in collection INSPECTION instruct donor to remove all unnecessary outer garments and to empty his/her pockets check items that may be used to adulterate the specimen Instruct donor to wash hands thoroughly National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

28. Inspection for possible specimen manipulation Wash hands thoroughly National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

29. National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

30. Steps in collection Indirect observed collection one at a time Pay close attention to collection When unusual behavior is seen, repeat procedure under DIRECT OBSERVED COLLECTION National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

31. Initial urine validity assessment National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

32. Steps in collection • measure the temperature • check volume • inspect physical characteristics • fill Step 2 and initiates Step 3 of CCF National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

33. Steps in collection Close and apply seal over the lid bottle in front of donor Sign over seal and indicate collection date and time Ask donor to fill up and sign Step 5 of CCF National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

34. Apply seal over the lid bottle in front of donor Affix signature to seal National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

35. Affix signature overlapping the cap and seal National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

36. Fill up and sign Step 5 of CCF Complete Step 3 of CCF National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

37. Documentation of the Testing Processes National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

38. Chain of custody The procedure to account for the integrity of each specimen or aliquot by tracking from point of specimen collection to its final disposition. National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

39. Custody and Control Forms (CCF) Forms use to document the security of specimen all steps of collection persons who handled the specimen status and integrity of specimen other pertinent information National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

40. Confidentiality of Records • Arrangement is made to ensure that the individual records are maintained with highest regard for individual privacy and confidentiality. • Any information relating to the donor of the specimen and the results of the assay on the specimen should be kept in a high security area to which only authorized individuals has access.

41. Non-biased Testing • Use of code for non-biased test • Confidentiality agreement / clause for all personnel for all personnel involved in testing process National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

42. General flow (cont) Require proper specimen transport & handling National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

43. National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City

44. We affirm, basic tenets of drug testing … • Protect client confidentiality and privacy • Uphold dignity and respect human right • Assure credible, scientifically supportable and legally defensible drug test results National Reference Laboratory East Avenue Medical Center East Avenue, Diliman, Quezon City