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5PSQ-041 Impact of introducing prefilled atropine syringes in ocular surgery: proactive assessment of drug costs and medication safety
  1. M Suominen1,
  2. Y Jeon2,
  3. N Koskinen1,
  4. R Latvakoski1,
  5. H Ruutiainen1,
  6. K Kvarnström1,
  7. S Kuitunen1
  1. 1HUS, HUS Pharmacy, Helsinki, Finland
  2. 2HUS, Head and Neck Centre, Helsinki, Finland


Background and Importance Intravenous atropine injection is used to treat acute bradycardia during ocular surgery. It has been observed that a significant amount of ampoule-drawn atropine injections were unused and wasted yearly in a large ocular surgery unit. Some potential medication safety risks have also been recognised. Although ready-to-use prefilled atropine syringes are recommended to improve medication safety of intravenous drugs, they are still rarely used in our country.

Aim and Objectives The aim of our project was to compare the drug costs and medication safety risks associated with the use of atropine ampoules and atropine prefilled syringes to treat acute bradycardia in ocular surgery.

Material and Methods First, the effects of prefilled syringes on drug costs were investigated by a literature search and by gathering data from other surgical units that already used prefilled syringes. Atropin-related drug costs of other surgical units were calculated before and after transition to prefilled syringes. After that, a Failure Mode and Effects Analysis ‘FMEA’ conducted by an interprofessional expert group was used to evaluate risks associated with the medication management and use process of both atropine products.

Results The introduction of prefilled syringes had decreased the costs of atropine injections in other surgical units more than 50% in average when compared to atropine ampoules. The savings we observed resulted mainly from wastage minimisation, because the shelf life of ampoule-drawn atropine injection is limited. Our literature search supported this observation. The FMEA analysis identified more medication safety risks related to the use of atropine ampoules (n=14, risk profile number ‘RPN’ 297) when compared to the prefilled syringes (n=7, RPN 74). The most significant difference came from the risks related to preparation of atropine injection (i.e. limited shelf life) and look-alike, sound-alike ‘LASA’-risks associated with the use of atropine ampoules.

Conclusion and Relevance Based on cost analysis and proactive risk assessment by FMEA the transition to prefilled syringes appears to decrease costs and increase medication safety.

Conflict of Interest No conflict of interest.

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