Single use vials - told by admins to use as multi-dose

Nurses General Nursing

Published

Specializes in Pediatric, g-tubes, trachs, Broviac line.

Help!! My patient receives 1 ml IV Lasix x3/day. The institution recently changed pharmacies and instead of 1 ml vials, we now have 2 ml single use vials. Since the patient's dose is 1 ml, I was told to save the vial with remaining 1 ml for the next dose. According to the CDC, this is not proper practice. I have sent the director of nursing the link to the CDC page but anticipate being told to continue using the single dose vial as a multi-dose vial.

Should I refuse to do this and, if so, how do I refuse and still keep my job? Help!!

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There are no preservatives (usually) in single-dose vials. Contact the pharmacy for their advice.

Tell the admins you are afraid for your license.

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Specializes in Pediatric, g-tubes, trachs, Broviac line.

Thanks for your reply. I will definitely contact the pharmacy and see what they say next time I'm on duty. Again, thanks for replying. I've lost sleep with worry over this!

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Pretty much what the other post said. If pharmacy agrees with you then you have someone else backing you up which is nice when arguing with your manager as she is not a pharmacist.

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Specializes in Pediatric, g-tubes, trachs, Broviac line.

Thank you :)

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An Amendment - - tell the admins that risk THEIR licensure, closure of THEIR facility for improper usage.

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Specializes in Pediatric, g-tubes, trachs, Broviac line.

Ah!! That should get their attention!!

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Specializes in ICU.

Concur with the suggestions given here. Please advise us as to admin response. Nurse Advocate Org.

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Specializes in Pediatric, g-tubes, trachs, Broviac line.

Thanks so much!! I will definitely advise as to their response. I'm not on duty again until the weekend so if you don't hear from me for a few days you'll know why.

I can't express how much I appreciate your replies. I had no idea who to turn to with this ...

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Specializes in Critical Care.

As the CDC points out, there is a proven risk to using a single dose vial for multiple patients, but for a single patient it's not the same documented risk, but not recommended. What our pharmacy does, particularly during drug shortages such as the recent lasix and morphine shortages, was to divide the vials into syringes and re-label them. Single dose vials do contain preservatives just like every other IV med.

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I would try to get it in writing too, if this is what they actually want you to do. If they are not willing to put it in writing, you will have your answer.

Protect your license, no one else will!

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Specializes in ER, ICU.

I'm always amazed at the cost saving ideas of bean counters. You are totally correct to defer to the CDC, I'll bet they have a better track record than your manager.

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