use. I used to have our pharmacy director look in our trash cans to
see what drugs we were throwing out. That's a good place to start to
identify drugs that may be better off purchased in prefilled syringes.
• Time. How much time do your nurses spend finding the vial of
medication, grabbing the proper needle, drawing it up, labeling it
and administering it to the patient? With a prefilled syringe, you just
grab the syringe and administer the medication. This could be a
huge time-saver, so you need to determine how much your staff's
time is worth and include that in your calculation.
• Waste. All vials accessed in the OR are single-use and many cen-
ters have adopted a policy to treat all of their vials, even multi-dose,
as single-use. So you're always throwing away some medication that
didn't make it into the syringe you just drew up. You spent $1 on that
10 mL vial of neostigmine, but you threw out 6 mL of it just now.
How much did you waste? You paid for the whole vial and used less
than half of it. You then have to factor in the costs of properly dispos-
ing of the unused medication. Do you buy disposable containers with
chemicals that render the medication unusable or do you buy car-
tridges for a wall-mounted disposal system? Switching to prefilled
syringes could reduce the number of containers or cartridges you
need to purchase.
• Materials. There's always the cost of syringes and needles to think
about, but if you're drawing up medications from ampules you need
to have a filtered needle. These extra materials need to make it into
your cost considerations. You also need a dedicated space, away from
patient care areas, to draw up the medications. Finding or creating
that space takes resources and time that you need to consider.
• Errors. Prefilled syringes can reduce the chance that a medication
is drawn up incorrectly or not labeled properly and given to the
wrong patient. There are many articles and statistics on medication
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