All vials and syringes should be wasted and discarded at the end of the procedure.
To some nurses, this can be an issue especially when there’s still medication left in the vial. Consider the disposal of the remaining medication as a safety step, rather than a waste of resources.
There has been much more attention recently on multidose vials, particularly the expiration date of these vials, especially from regulatory organizations such as CMS and The Joint Commission. Dolan, RN, MS, CIC, from the Department of Epidemiology at Children’s Hospital in Aurora, CO, and lead author of “APIC position paper: Safe injection, infusion, and medication vial practices in health care.” This Q&A accompanies an article published in the September issue of Briefings on Infection Control.
A: Multi-dose vials have been and continue to be a confusion for healthcare personnel (HCP) because they either are not fully aware of or do not follow basic infection control practices as they pertain to vials.
Consider the following scenarios from recent mock surveys and questions submitted to Compass Clinical Consulting: Pharmacists and nurses alike should carefully evaluate the use of multi-dose medications.
The SIPC emphasizes the importance of the “one syringe, one needle” approach to all medication use.
Do you arrange infection control training for your healthcare personnel?
Standard MM., EP 8 requires that all expired, damaged, and/or contaminated medications are removed and stored separately from medications available for use.
Facilities should have a designated clean medication area where injections are drawn up and labeled immediately before each individual patient.Otherwise, insulin pens should be issued for each individual patient and use.The urge to use single dose vials for multiple patient use is often driven by poor habits and unfounded assumptions.To be in compliance with MM. EP 8, The Joint Commission requires organizations to re-label multi-dose vials with a revised expiration date once the multi-dose vial is opened or punctured.If the manufacturer's original expiration date is shorter than the revised expiration date then the shorter date must be used.