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 The Medical Review Officer's Manual - MROCC's Guide to Drug Testing,Third EditionRobert Swotinsky, MD, MPH | Donna R. Smith, PhD. $89.00 Product Code: 23091 Buy It Written by practicing MRO's with years of experience, this new manual delivers a payload of precise instruction on the performance and interpretation of drug and alcohol testing in the workplace. You will find everything you need to prepare for the MRO certification as well as practice the full range of current standards. Inside you will find: Step by step procedures for work related drug and alcohol testing in both the regulated and non regulated arena, including: • Uring collection • Lab analysis • MRO review of drug test results • Reporting and record keeping Current regulations for • Federal drug and alcohol testing laws • The new Department of Transportation procedures • State drug and alcohol testing laws Concise yet comprehensive answers to your most pressing questions such as: • How do I handle invalid, adulterated or substituted test results? • How can I be sure I'm in full legal compliance? • How can I ensure that every test I perform is accurate, reliable, correctly interpreted and fair? Sponsored by the Medical Review Officer Certification Council, the Medical Review Officers Manual is your best source for today's highest standards of practice in workplace drug testing. Order your copy today! Table of Contents 1.The Medical Review Officer (MRO) MRO Responsibilities MRO Assistants MRO Coverage While Away MRO Qualifications Other Roles of Physicians Who Serve as MROs Avoiding Conflicts of Interest with Laboratories Risk Management 2. Laws, Guidelines, and Policies Military Testing Programs Federal Drug and Alcohol Testing Laws State Drug and Alcohol Testing Laws Canadian Workplace Testing Unionized Workplaces Employer Policies Americans with Disabilities Act Clinical Laboratory Improvement Amendments Emergency Medical Treatment and Active Labor Act Food and Drug Administration Health Insurance Portability and Accountability Act Student Drug-Testing Programs Effectiveness of Workplace Drug Testing 3. Test Types Pre-employment Testing Testing Reasonable Suspicion/Cause Post-accident Testing Random Testing Return-to-Duty Testing Follow-up Testing Periodic Testing 4. Employer Responsibilities Employee Training Designation of Employer Representative Employer Actions after Receiving Test Results Background Checks Stand-Down Procedure Management Information System Reports Blind Specimens Employer Recordkeeping 5. Service Agents Specimen Collector and Breath Alcohol Technicians Laboratories Medical Review Officers Consortia/Third-Party Administrators Substance Abuse Professionals Public Interest Exclusion Who Pays for Tests? 6. Specimen Collection Collector Qualifications Collection Sites Custody and Control Forms Donor Arrival Regulated and Nonregulated Tests at the Same Visit Donor Identification Release and Consent Forms, Waivers, and Medication Lists Removal of Outer Clothing and Inspection of Personal Items Urine Collection Procedure for Shy Bladder Urine Collection for Alcohol Testing Hair Collection Oral Fluid Collection Sweat Collection Blood Collection Refusal to Take a Drug Test Distribution of Custody and Control Form and Recordkeeping Specimen Shipment 7. Laboratory Analysis Laboratory Certification Laboratory Performance Testing and Quality Control Accessioning Specimen Validity Testing Drug Testing and Cutoff Values Initial and Confirmation Drug Tests Hair Analysis Oral Fluid Analysis Sweat Analysis Laboratory Review Reporting Laboratory Results Storage of Specimens and Records Laboratory Statistical Reports Data Package Instrumented Initial Test Facility Point-of-Collection Test Devices 8. Test Results Negative Result Positive Result Invalid Result Adulterated Specimen Substituted Specimen Dilute Specimen Specimen Rejected for Testing 9. MRO Review of Drug Test Results Receipt of Forms and Results Review of Forms Concentration Reports Dilute Results Cancelled Tests Contacting the Donor Interviewing the Donor Review of Invalid Results Review of Adulterated and Substituted Results Review of Positive Results Corroboration of Medical Explanations Medical Qualification and Safety Concerns Drug Tests and Impairment Making the Determination Multiple Results from the Same Specimen Informing the Donor of the Outcome and Right for Split-Specimen Testing or Retesting Can I Take Another Test, Doc? Reporting the Determination Reporting Multiple-Specimen Result from the Same Collection Event Data Management Software Record Retention Access to MRO Records Changing the Determination 10. Special Circumstances Drug Tests and DOT Physicals Passive Exposure Illicit Drugs in Foods and Beverages Borrowed Medications Misuse of Ones Own Prescription Medication Foreign Prescribed Medications DNA Testing 11. Alternative Specimens Comparisons between Specimens Point-of-Collection Tests Blood Specimens Urine Specimens Hair Specimens Oral Fluid Specimens Sweat Specimens 12. Split Specimen Tests and Reanalyses Laboratory Reconfirmation Analyses (Reanalyses) MRO Procedure for Split Specimen Testing Split Specimens and Multiple Non-negative Results Payment 13. Pharmacology, Metabolism, and Interpretation of Alcohol and Specific Drugs Alcohol Amphetamines Barbiturates Benzodiazepines Cocaine Lysergic Acid Diethylamide (LSD) Marijuana Methaqualone Opiates and Opioids Phencyclidine 14. Workplace Alcohol Testing Breath Alcohol Technicians and Screening Test Technicians Alcohol Test Devices Alcohol Testing Form Alcohol Test Procedure Insufficient Specimen Test Cancellation Refusal to Take an Alcohol Test Reporting Results Fitness-for-Duty Determination 15. Return to Duty Process Substance Abuse Professionals Responsibilities SAP Qualifications Referral to the SAP Initial SAP Evaluation Referral for Treatment Follow-up Evaluation Return to Duty Testing Follow-up Testing Return to Duty Agreement Changing SAP Recommendations Reinstatement of Credentials Issued by the Coast Guard Recordkeeping Appendixes A Information Sources B The Medical Review Officer Certification Council C MRO Code of Ethical Conduct D Controlled Substances Act, Schedules I-V E DOT Procedures, 49 CFR Part 40 F Federal Drug Testing Custody and Control Form (CCF) About the Authors Robert Swotinsky, MD, MPH, an occupational physician and medical review officer with Fallon Clinic and MetroWest Medical Center, is Founding Editor of the MRO Update newsletter. Donna R. Smith, PhD, regulatory Affairs and Program Development Officer at FirstLab Inc., was formerly Director, Drug Enforcement and Program Compliance, U.S. Department of Transportation and principal author of the DOT drug and alcohol testing rules. |
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