Celebrating Nurses’ Monumental Impact
There is a myriad of ways to participate in National Nurses Week, which is celebrated May 6-12, from honoring your staff RNs with a gift or event to taking steps to let...
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By: Sheldon Sones
Published: 4/8/2021
If you're considering prefilled syringes for your facility, a little perspective goes a long way. It doesn't make sense to do an apples-to-apples cost comparison of prepackaged medications with vial-filled versions of the same drugs. There are several indirect and intangible benefits to the prefilled syringe equation, and until you've examined them from all angles, you aren't going to get a full picture of how ready-to-administer meds contribute to cost-effective, efficient and safe patient care.
It's also important to consider that multiple-dose vials should not be used for more than one patient, meaning you're often forced to discard at least some unused medication at the end of case. If you're regularly wasting even half of the medications you purchase, chances are prefilled syringes will be less costly and more efficient in the long run. When you consider these factors, the gap shrinks between the cost of prefilled syringes and manufactured medications.
In my role as a pharmacy consultant, I observe the types of medications facilities tend to purchase in prefilled syringes. The most common options tend to be emergency drugs that facilities like to have ready for immediate administration such as rocuronium, succinylcholine, ephedrine and phenylephrine. A variety of ophthalmic medications such as moxifloxacin and cefuroxime used for intracameral administration that require very specific dosing are also commonly bought in prefilled syringes. An added benefit of getting ophthalmic drugs from a compounder: They tend to be products that cannot be reliably duplicated without a lot of preparation and effort.
It's understandable why some facilities and providers might still have reservations about collaborating with a compounding pharmacy after contaminated medications prepared by the New England Compounding Pharmacy caused the 2012 meningitis outbreak that killed 64 patients and sickened hundreds more. Since that tragedy, however, the FDA has done everything possible to mitigate safety concerns about compounding pharmacies through comprehensive, on-site inspections and standard compliance reviews. Ultimately, however, it's up to you to do your due diligence into any compounding pharmacy with which you're thinking of working.
To research the reputation of compounding pharmacies, start with the American Society of Health System Pharmacists (ASHP), which offers a number of references — such as the ASHP Guidelines on Outsourcing Sterile Compounding Services (osmag.net/S9SUbb) — and position statements at no charge, as well as a number of additional tools that are available to members of the organization.
Another valuable tool is the FDA's compounding pharmacy inspection data. The FDA is an open book when it comes to its inspections and publicly lists any discrepancies it finds — large or small — during the inspection process, which has raised the bar for quality standards among compounding pharmacies. An important note: the FDA's inspections list every ding, no matter how slight. You need to understand the differences between major problems that should be a deal-breaker and minor issues that shouldn't automatically disqualify a potential compounder.
At the end of the day, patient safety is the ultimate goal. And the fact of the matter is pre-mixed, pre-labeled medications from a well-vetted compounding pharmacy are generally safer and more precisely prepared than many medications mixed in the OR — especially at high-volume facilities where staff are under a lot of pressure to keep the surgical schedule on track and limit turnover times between cases.
The decision to opt for prefilled syringes ultimately comes down to understanding your facility's short- and long-term needs. In the final analysis, for many leaders, the multiple benefits of buying prepackaged medications tips the scales favorably toward these products. Prefilled syringes provide the advantage of immediate access, no provider labeling, extended expiration dates (in certain cases), medication quantities that meet your facility's specific needs and robust FDA oversite of standards compliance. After weighing all the factors, particularly for emergency medications and ophthalmic preparations, you'll find this option more attractive than it might have appeared at first glance. OSM
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