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Conducting an audit of controlled drugs

All veterinary facilities in Ontario must maintain a controlled substances register, commonly referred to as a controlled drug log. The controlled drug log is a system for recording the inventory of controlled drugs, including purchases, sales and in-facility dispensing.

Maintaining a Controlled Drug Log

The Accreditation Standards for Veterinary Facilities in Ontario requires all facilities complete monthly (every 21 to 31 days) audits of their controlled drugs. An audit reconciles the actual inventory and the expected inventory determined from the controlled drug log. Frequent audits assist with inventory management and ensure irregularities are detected, resolved and reported in a timely fashion.

Following an established, written protocol for audits can help cut down on errors and inaccuracies.  It is a good idea to rotate the auditor role within the facility. Auxiliary staff can perform audits; however, it is ultimately the veterinarian’s responsibility to ensure the security of controlled substances. As part of the audit protocol, the veterinarian should be reviewing the controlled drug logs and audits.

Conducting a Controlled Drug Audit

The steps in performing a controlled drug audit are as follows:

This is the quantity of a drug you expect to have on hand, based on the information contained in the controlled drug log and other records, such as purchase invoices.

Determine the actual inventory by examining and, in some cases, physically counting the stock. 

The actual inventory includes the quantity in unopened bottles and the amount in opened bottles.

Tamper proof seals can save time.  For added security, a tamper proof seal can be wrapped around unopened bottles.  If this seal has not been broken, the auditor can assume the bottle contains the number of tablets or mls as per the label. 

During the audit, open bottles of tablets are counted and they then can be sealed as well. For the next audit, if the seal has not been broken, a re-count would not be necessary.

In the case of an opened bottle of an injectable controlled drug, do not withdraw the liquid to determine the volume as this can lead to contamination and loss of the drug.  There are a number of ways that injectable medications can be “counted”. To maintain a running account of the amount of liquid remaining in an opened bottle apply a sticker to the bottle which denotes the amount remaining after a withdrawal.

Compare the actual inventory to the expected inventory.  These numbers should be identical or very close. (Note: Loss allowance due to withdrawal is normally between 0.1 and 0.2 mls per withdrawal.) 

Document the Controlled Drug Audit

Audits can be documented by notes written on every log sheet, using one line of the log.

Sample form for a Controlled Drug Audit

Alternatively, audits can be documented using a tracking sheet.

Sample form for a Controlled Drug Audit Tracking Sheet

A tip sheet for conducting a controlled drug audit contains the key things to remember.

Tip Sheet for Controlled Drug Audits

Controlled Drug Log: Instructional video

The Maintaining a Controlled Drug Log video explains how to maintain a proper drug log in a veterinary practice.

Controlled Drug Audit: Instructional Video

The Conducting a Controlled Drug Audit video explains appropriate methods of measuring controlled drugs and what to do when irregularities are identified.