Background The increase in drug spending and the decrease in resources make it necessary to look for strategies for minimising costs.
Purpose To describe the strategy for administering high-consumption intravenous drugs (IVd) directly and estimating the associated resources saved in an Intensive Care Unit (ICU).
Materials and Methods We obtained a list of drugs whose consumption in the ICU was more than 1,000 units/year.
After a literature review, we selected those that could be safely administered via IVd but are usually administered in intermittent intravenous infusion. We prepared a table containing instructions for their reconstitution and administration.
For four weeks two nurses administered the medicines that had been prescribed and were included in the table via IVd, recording: drug, time spent in preparation & administration and adverse reactions related to the route of administration.
After collecting data
We estimated the direct cost savings in fluids if all drugs consumed by the unit and included in the table had been administered by IVd during 2010.
We compared the time spent on the preparation and administration of drug doses used in routine practise versus time used to implement this strategy.
Results The ICU used more than 1,000 units/year of each of 39 intravenous drugs, of which 12 were included in the table: metoclopramide, colistimethate, hydrocortisone, phytonadione, pantoprazole, amoxicillin/clavulanic acid, dexamethasone, piperacillin/tazobactam, furosemide, methylprednisolone, meropenem and ranitidine.
The nurses made 117 administrations via IVd (following the usual procedure) of these drugs. The average time was 6.5 minutes for preparation and administration of each dose and no adverse reactions were detected related to the route of administration.
We estimate the ICU can save 28,000€/year.
Conclusions Direct IV administration can be safe and efficient.
The extension of a programme of this type throughout the Hospital could increase efficiency and rational use of medicines significantly.
No conflict of interest.
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