Background US recommendations on patient safety support the use of point-of-care activated systems (POCAS) for infusion of labile drugs but this concept is almost unknown in Europe, which mainly uses syringe & needle (SYRNE) or transfer-set (TRASE) methods performed by nurses.
Purpose To identify and publicise the added value of POCAS on quality of care.
Materials and methods The authors conducted 4 different studies in 4 unrelated hospitals to compare POCAS versus the SYRNE method (or TRASE method when available). The POCAS chosen, assembled in our CIVAS facility, was Augmentin 1g phial linked to a 50-mL saline Viaflo bag via a EuroVialMate connector. Reconstitution/administration (n=944) was performed by 44 nurses unfamiliar with POCAS and scored with subjective and objective measurements.
Results All medians were adjusted to 100%-excellence scales so that the SYRNE method (or TRASE method when available) scored 50%. When results were rated on this scale, 7 significant arguments emerged in favour of POCAS: 1) Product quality due to standardised batch production: 92% versus SYRNE (89% versus TRASE), 2) Outsourcing opportunity for small hospitals without PICs-compliant facilities, as encouraged by Belgian health authorities, 3) Patient safety: 94%, due to less risk of bacterial contamination (closed system), 4) Nurse safety: 94%, due to no contact with sensitising drugs and less risk of needle pricks, 5) Intuitive training (3 administrations) and ease of use: 90% (or 89%), 6) Cost containment due to just-in-time reconstitution (15%) and 44% time gain versus SYRNE, 7) Ecological impact: 91% (or 89%), due to no syringe, less metal, less waste and no dioxin production during incineration.
Conclusions The authors recommend POCAS for daily routine infusions of labile drugs.
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