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distinguish between medications that look or sound alike, which Ms. Allen says further reduces the risk of compromising patient safety. Pharmacy consultant John Karwoski, RPh, MBA, says prefilled syringes' clear labeling and tamper-resistant packaging minimize the risk to patients and the exposure to surgical facility leaders. "It's getting tougher and tougher to control, because of demands on time, with the nurse or the CRNA or the anesthesiologist expected to do so much these days," says Mr. Karwoski. "It's a question of: What is the standard of care coming to? That's why I think we're at the cusp now of seeing [prefilled syringes] becoming more mainstream." Burden or bargain? Ask surgical facility leaders what's keeping them from adopting pre- filled syringes, and you will likely hear a common refrain: "cost." Yes, prefilled syringes typically have a higher per-unit cost, but phar- macy consultant Sheldon Sones, RPh, FASCP, is of the mind that prefilled syringes can ultimately save money. He cites time efficiency and reduced drug shortages, as well as their ability to mitigate "the inherent waste" — and regulatory expectations — associated with using multi-dose vials in the OR. Take ephedrine at $50 to $60 for an ampule as an example. Say you have to throw out the 3 vials of ephedrine that go unused. "You're talk- ing $150 a day — more than $700 a week, almost $40,000 a year — just down the drain," says Mr. Sones. Compare that with ephedrine in a preloaded syringe. "It might cost $10 and it's going to have a shorter expiration date," he says, "but it's still a bargain." Cost certainly entered the discussion for Apollo Surgery Center, but Ms. Allen says the surgery center ultimately found that prefilled syringes helped to save money on the back end. It helped staff get a better understanding of usage and ultimately control wastage. 1 0 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J a n u a r y 2 0 1 7