opened multidose vials- when to discard??

  1. 0 Our nurses are in disagreement with our pharmacy policy that "opened multidose medication vials will be discarded by the manufacturer expiration date- unless the practicioner suspects contamination"-
    I thought that once a vial was opened- especially insulin- it loses its potency after 30 days...
    We have a 10 ml vial of Compazine on our cart that expires in 2004!! That really bothers me that it could be used for so long- especially if used infrequently...
    Am I crazy?
    What is your policy?
  2. Visit  Smitty,RN profile page

    About Smitty,RN

    From 'Florida'; Joined Jun '00; Posts: 23; Likes: 1.

    16 Comments so far...

  3. Visit  lpnandloveit1 profile page
    0
    I have always been told that the manufacturers exp date was for sealed unopened vials.
  4. Visit  puzzler profile page
    0
    The policy at every hospital I have worked at over the last 24 years has been to discard the "opened" vial after 72 hours.

    Personally, I would not use anything older than that. I believe the expiration date is for unopened vials. I would expect that you could get some info from the manufacturer on this topic.

    Good luck
  5. Visit  fiestynurse profile page
    0
    The policy here is to discard after 3 months from date of opening multidose vials. That is the JCAHO standard.

    http://www.ismp.org/MSAarticles/Multidose.html
    Last edit by fiestynurse on Jun 26, '01
  6. Visit  moonshadeau profile page
    0
    30 days is the norm at my hospital and at most other places that I have worked. This includes insulins as well. Also, our institution requires that all medication be withdrawn from the vial prior to disposal of bottle. I don't know maybe we are using smaller dose vials but the best rule should always be one vial, one patient. About the only exception that I can think to this would possibly be a Lidocaine or something it that class.
  7. Visit  ornurse217 profile page
    0
    Just recently the pharmacy policy changed to discarding the vial when it expires. My question has always been, How do you know if it is contaminated? Too many people have access to these vials and you can't always guarantee that they used aseptic technique when accessing. WHEN IN DOUBT, THROW IT OUT!
  8. Visit  nsmith_rn profile page
    0
    I try to aviod useing vials that others have used
    I do not know where they have been nor what has been done to them
    Insulin however cannot be avoided
    however things like compazine, Zofran
    I only give it if I am the one to open the vial
    never know what happened before you
  9. Visit  bassbird profile page
    0
    I'm a pharmacy tech and asked one of the pharmacists that very question last week. I was surprised when she told me that the policy is the manufacturers exp. date. I always label when the vial was opened, etc. Our vials are kept in the refrigerator with a foil cap after they are opened. It doesn't make sense to me that the vials would be good until the manuf. exp date once they have been entered either.

    I just thought I would mention that compazine is cheap but Zofran (the 20ml vial) has a pharmacy cost of $165!

    I wonder, is the policy is set by the individual hospital pharmacy or what?

    I agree about feeling uncomfortable using the same vial others have used. I work with one tech who never labels when he hangs bulk bags in the sterile hood. My theory is if it isn't labeled I toss it and start over.
  10. Visit  bassbird profile page
    0
    I asked our Pharm D to clarify the expiration situation. She said that single dose vials must be used within 12 hours after entering if left at room temp and within 24 hours if kept in the fridge.

    Multi-dose vials are good for 30 days in the fridge after being entered. I asked about insulin (since in my clinical it's kept in the med cart) and she said that is also good for 30 days even when not in the fridge.

    I hope this helps.
  11. Visit  misti_z profile page
    0
    I know this is an old thread but I thought it was worth the post:

    Our hospital policy is 30 days as well. It is also policy to label the vial with the date if you are the one who opens the box, this sometimes does not get done, so I avoid using it.
  12. Visit  P_RN profile page
    0
    Let me tell you a little story that actually happened.

    We had a nurse (RN) who was always volunteering to "help" other nurses give PRNs and was a "whiz" at IVs.
    Wow we said, she sure has energy. What a gal!

    Well to make a long story short, she was "helping" herself to at least half of every tubex/syringe of Meperidine or Morphine she gave. She kept 2 multiuse normal saline 10cc vials in her pockets.....of course......one for morphine, one for meperidine.

    She was finally caught when a little old lady (who wasn't senile) went to the VP for nursing and filed a complaint that she had not gotten relief from an injection.

    She was caught with 17 Tylox, 10 tubexes of morphine and her 2 vials in her uniform pockets!! What if she had laid one down and someone irrigated with the "saline" thought to be in it?

    Since that time, if I have not opened the vial myself I refuse to use it. And if I use it I throw away the rest. Case settled.

    Price be darned....I am not going to give ANYthing that could be contaminated with ANYthing.
  13. Visit  nsmith_rn profile page
    0
    I do the same thing..... not even a saline bottle will I use after someone else
  14. Visit  fiestynurse profile page
    0
    There sure is a good argument here for the use of single-dose vials. Not only would it be safer, but it would probably cost less.


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