PA Pt Safety Advisory: Unsafe Injection Practices Issue

[nurseprnRN, BSN, RN]

Re: Drug shortages and unsafe injection practices.

In the December 2012 issue of the Pennsylvania Patient Safety Advisory, (http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2012/Dec;9(4)/Pages/150.aspx_) Jeffrey Bomboy, Patient Safety Liaison, Northeast Region, discusses the effects of drug shortages on unsafe infection practices. In this extremely important advisory article, Mr. Bomboy discusses how national drug shortages have become a factor in unsafe injection practices in healthcare facilities and how practitioners rationalize that the reuse of single-dose vials on multiple patients can reduce costs without risks.

As a patient safety liaison for the Pennsylvania Patient Safety Authority sharing information on current drug storages with my peers and facilities, some facilities have stated they are using single-dose vials for more than one patient in order to conserve resources and prevent waste. There are other rationalizations for the misuse of single-dose vials, including efficiency, time constraints, conservation of resources, avoidance of waste, and cost considerations.

No matter what the rationalization is, the improper use of single-dose vials continues to result in infection outbreaks.

Vials intended for single use are labeled "single-use" or "single-dose" because these vials contain no preservatives or antimicrobials to prevent bacterial contamination. Because such contamination is not visible to the human eye, it must be assumed that once the stopper is penetrated or the ampule is broken, contamination occurs, posing a risk of infection to the patient who next receives contents withdrawn from the vial.

If you are unfamiliar with the issues related to the reuse of single use vials, the impact of drug shortages, and the risk of infection outbreaks from unsafe injections, please take the opportunity to read this Patient Safety Advisory. It provides an excellent summary of the issues involved.

[hiddencatRN, BSN, RN]

I never reuse single dose vials, but it does break my heart a little to take 5 cc from a 20 cc bottle and trash the rest. Add preservatives, or make single use vials come in smaller unit amounts! It always feels so wasteful.

[JZ_RN]

We get pre-packaged single use syringes of medication or use multi-dose vials, the single dose vials are not always a "single dose" and there's no sense wasting medication or creating a possible infection risk.