SIG – Use of prefilled syringes in intensive care units and operating theatres

Link to EAHP Statements

• Section 4 – Clinical Pharmacy services – 4.2, 4.3, 4.5
• Section 5 – Patient Safety and Quality Assurance – 5.2, 5.3, 5.4, 5.5, 5.6

Abstrat:

Patient safety lies at the heart of all representations made by the European Association of Hospital Pharmacists (EAHP) and its member associations. In the clinical setting, where decisions are often made quickly or under stress (e.g., emergency department, intensive care units, operating theatres, during urgent interventions), medication error rates preparing injectable drugs from vials and ampoules can be high.

Prefilled syringes support patient safety improvement as well as medication error and medicine waste reduction. Since their availability and viability in relation to the different levels of resources available to hospitals across Europe varies, the European Association of Hospital Pharmacists (EAHP) decided to investigate this topic further and created a Special Interest Group (SIG) on the Use of Prefilled Syringes in Intensive Care Units and Operating Theatres (financially supported by BD). This SIG was tasked with looking at the cost/benefits and viability of prefilled syringes in relation to the different levels of resources available to hospitals across Europe. 

Preliminary data suggested that prefilled syringes (PFS) can ensure sterility and help reduce medication errors associated with dosing errors and related costs. The work of the SIG aimed at the development of a value framework for using multiple criteria decision analysis to support evidence-based implementation and purchasing.

To create the value framework for a multiple criteria decision analysis instrument that could support value-based purchasing and utilisation of PFS the SIG conducted a literature review and ran three surveys to gather feedback from professional associations, healthcare professionals and PFS manufacturers.

The literature review demonstrated that in the preparation and administration of injectable medicines in operating theatres and ICUs, PFS are associated with reduced number of preparation steps and associated cognitive complexity, simpler use (no labelling needed on the point of care as already correctly labelled), reduced infection rates (reduced microbiological contamination), reduced drug, disposables and packaging wastage, reduced nursing time allocated to the preparation and administration of drugs, quicker to administer in an urgent crisis situation, reduced the likelihood of medication errors, reduced needlestick injuries and overall cost savings.

For the opinion questions included in the surveys there are high and good levels of overall agreement to half of the statements on the use of PFS among the healthcare professionals that participated. Based on the results and their discussion, the SIG concluded that the availability of PFS differs widely in Europe.

The SIG has developed a set of recommendations that will be presented during the session.

Learning objectives:

After the session, the participant should be able to:

• Gain an overview of the work done by the SIG on the use of Prefilled Syringes in Intensive Care Units and Operating Theatres
• Gain an understanding of the multi criteria decision analysis
• Understand the status of the use of Prefilled Syringes in Europe and the potential benefits and potential risks associated with prefilled syringes identified by the SIG during their thorough literature review
• Identify the different components to be considered by decision-makers in hospitals when introducing PFS or adding new active substances of the prefilled-syringes in the hospital formulary.
• Identify the set of recommendations proposed by the SIG

Educational need addressed.

What was the work done by the SIG on the use of Prefilled Syringes in Intensive Care units and Operating Theatres? What is the status on the use of prefilled syringes in Europe? What are the benefits and risks when introducing new prefilled syringes in the hospital?

Keywords

Prefilled-Syringes, intensive care units, operating theatres, patient safety, hospital formulary, Special Interest Group