Background Before infusion with a syringe pump, drug preparation requires often dilution and more steps compared to most other injection practises, thus involves risks for patients and Health Care Workers (HCWs). The literature indicates that prefilled syringes (PFSs) address these issues successfully but most data do not apply to intravenous infusions.
Purpose BD ran a multicentre study to evaluate the expected impacts of a new BD Sterifill 50 ml PFS on patient and HCW safety, comparing an infusion with a syringe pump using either the PFS or a conventional system (drug in ampoule, diluent, 50 ml syringe filled at time of use).
Materials and Methods 120 HCWs performed infusions in a randomised order, 4 with the new PFS, 4 with the conventional system, mimicking regular dobutamine preparation and infusion (250 mg/ 50 ml, 10 ml/h). For all 960 cases, an observer recorded any handling errors. Results were analysed by sub-groups using FDA Human Factors guidelines. A risk score was calculated for each syringe type and for each step based on the error occurrence and its severity according to the risk class: dosing error, microbial contamination and unexpected adverse event. This Health Hazard Risk Evaluation (HHRE) method has been published by BD.
Results With PFSs the handling error rate was lower and the HHRE score was better. Dosing error and microbial contamination occurred respectively in 12.7% and 43.1% of infusions with the conventional system but only in 4.8% and 0.2% with PFSs. 6% of conventional system infusions showed a risk of needle stick injury (one injury actually happened) versus 0% for PFS.
84% of HCWs would use the new PFS in their daily practise mainly to decrease the risk of contamination and administration errors, and to save time.
Conclusions Prefilled 50 ml infusions with a syringe pump help reduce patient risks (especially dose error and contamination) and HCW injuries. PFS is also preferred by HCWs.
No conflict of interest.
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