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3PC-004 Drug waste of ready-to-administer syringes in the intensive care unit: aseptically prepared syringes versus prefilled sterilised syringes
  1. T Van Gelder1,
  2. A Lalmohamed1,
  3. K Dorst-Mooiman1,
  4. J Dekker1,
  5. M Schinkel1,
  6. M Sikma2,
  7. E Uijtendaal1,
  8. T Egberts1
  1. 1University Medical Centre Utrecht, Clinical Pharmacy, Utrecht, The Netherlands
  2. 2University Medical Centre Utrecht, Intensive Care Unit, Utrecht, The Netherlands


Background and Importance The availability of ready-to-administer (RTA) syringes for intravenous drugs facilitates rapid and safe administration in emergency and intensive care situations. However, the preparation of these syringes in hospital pharmacies via aseptic batchwise filling results in significant drug waste due to excess production and their limited microbiological shelf-life of 31 days, which contributes to considerable environmental pollution. RTA sterilised syringes have much longer shelf-lives (up to 36 months) than aseptically prepared RTA syringes and might contribute to reducing drug waste.

Aim and Objectives This study aimed to evaluate the difference in drug waste between RTA syringes that were prepared through aseptic batchwise filling in the hospital pharmacy and RTA sterilised syringes (produced in a large-scale compounding pharmacy) in the Intensive Care Unit (ICU).

Material and Methods In a 32-bed mixed medical-surgical ICU, drug waste of RTA syringes was measured over an 8-year period from August 2015 to May 2023. An intervention group of three drug products that were replaced by RTA sterilised syringes (potassium chloride 60 mmol = 60 ml, midazolam 50 mg = 50 ml and morphine 50 mg = 50 ml) was compared to a control group of five drug products that were not replaced by sterilised syringes during the study period. Statistical analysis included a Kruskall-Wallis test along with two interrupted time series (ITS) analyses to assess and visualise the effect of different study periods on waste percentages.

Results A total of 319,621 RTA syringes were dispensed by our hospital pharmacy during the study period. Introduction of RTA sterilised syringes significantly decreased drug waste of RTA syringes irrespective of drug type in the intervention group, from 31% before introduction to only 5% after introduction (p<0.001). The control group showed no significant decrease in drug waste over the same time periods (from 20% to 16%; p = 0.726). The ITS model of the intervention group showed a direct decrease of 17.7% in waste percentage after the introduction of the RTA sterilised syringes (p = 0.083).

Conclusion and Relevance RTA sterilised syringes can significantly reduce drug waste in the ICU, supporting hospitals to enhance environmental sustainability.

References and/or Acknowledgements None.

Conflict of Interest No conflict of interest.

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