Diversion of injectable medications in healthcare is a challenging issue in infection prevention that can result in transmission of infections, especially bloodborne pathogens. In the midst of the opioid epidemic, drug diversion is increasing, yet infection prevention's (IP) role remains ambiguous. We describe a collaborative educational approach to promote drug diversion awareness.

The State Health Department (SHD) and local Association for Professionals in Infection Control and Epidemiology (APIC) chapter formed a committee to plan a one-day conference on injection drug diversion. From August-October 2018, the committee met bi-weekly via webinar to prepare for the November 13th conference. The overall conference objective was to help attendees understand healthcare/public health's role in diversion investigations. The didactic conference included educational presentations and a discussion-based exercise. To assess diversion awareness, eight questions (6 multiple choice, 2 free text) were incorporated into the discussion-exercise using an interactive audience polling tool. Evaluation forms included 40 questions to rank presentation/conference quality on a scale of 1 (poor) to 5 (excellent).

There were 141 conference attendees. The majority represented IP (28%), public health (25%), and pharmacy (13%). The average number of attendees that responded to polling questions was 25.3 (range 20, 31). Respondents reported 52% (13/25) had been involved in a diversion investigation. Five (23%) reported that staff at their facility receive diversion training. Nearly half [48% (15/31)] did not know if their facility had an internal mechanism to report diversion. Evaluations were completed by 75 (53%) attendees with an average score of 4.5 (range 3.6, 5).

It was beneficial to team resources of SHD and local APIC to host a conference. The discussion-based exercise revealed gaps in diversion prevention, detection, and response. It is imperative that healthcare and public health gain clarity in each other's roles in drug diversion and have tools to manage these detrimental events.