Background Our pharmacy department (PhDp) prepares IV mixtures (IVMs) centrally, for example antifungal drugs. 2 quality indicators (QIs) assess the prescription, distribution and administration process: %IVMs returned from clinical units (standard <20%) and %IVMs recycled (standard > 80%), considering that all returned IVMs are validated by a pharmacist to ensure their validity in terms of stability and storage conditions. Also, 2 efficiency indicators assess cost savings: savings from centralised PhDp preparation compared with preparation in clinical units, and savings from recycling antifungal IVMs. Global median %IVM returned is 11%.
Purpose To describe and evaluate this process and the efficiency of quality indicators.
Materials and Methods Prospective study. Period: 1 year (2011). Academic General Hospital (1,500 beds). Antifungal drugs: liposomal amphotericin B, anidulafungin, caspofungin, voriconazole. Variables: process and efficiency quality indicators. Data source: daily log sheet preparation and return of IVM, and antifungal and infusion solution direct costs; personnel costs weren’t considered.
Results 3,643 antifungal IVMs were prepared: 35% caspofungin, 32% voriconazole, 21% liposomal amphotericin B, 12% anidulafungin. Process QI: 6.40% antifungal IVMs returned (mainly voriconazole: 10%) and 87% antifungal IVMs recycled (mainly caspofungin: 100%). Total savings: €222,351. Efficiency of the QIs: €155,694 savings from PhDp centralization (mainly voriconazole: €78,659) and €66,657 savings from recycling (mainly caspofungin: €33,025).
Conclusions The fact that process quality indicators comply with standards and the very large cost savings for the institution, support PhDp antifungal IVM centralization. Voriconazole IVM centralization allows more cost savings and caspofungin is the most recycled.
No conflict of interest.
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