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October 19, 2011
8:00:00 AM - 11:00:00 AM
Hall A1 South Area G
Pre-filled, Pre-labeled Syringes in the Operating Room: Provider Acceptance
James H. Abernathy, M.D., D Wagner, Pharm.D, Christopher Fortier, Pharm.D, M Shepherd, Pharm.D, Orin F. Guidry, M.D.
Medical University of South Carolina, Charleston, South Carolina, United States
INTRODUCTION: It is estimated that one significant medication error occurs in every 133 anesthetics and 1 out of every 250 of these errors is thought to be fatal. The Anesthesia Patient Safety Foundation (APSF) recommends a new paradigm for reduction of medication errors which includes pre-filled medication syringes (PFS). We tested the hypothesis that providers do accept this change in clinical practice.

METHODS: Two large academic medical centers (Medical University of South Carolina Medical Center and University of Michigan Hospitals and Health System) converted commonly used operating room (OR) medications from medication vials to PFS. Following Institutional Review Board approval a 12-question electronic survey was created to test the hypothesis by evaluating clinician satisfaction of PFS. The survey was administered to anesthesiologists, certified registered nurse anesthetists, pharmacists, pharmacy technicians, and anesthesia technicians, 1-month after introduction of the PFS conversion. Data were analyzed using a student t-test for continuous variables and a Fisher’s exact test for nominal variables.

RESULTS: There were a total of 58 respondents (24-South Carolina, 34-Michigan) with the majority (80%) describing the conversion to PFS’s as “positive” and 79.3% believed that PFS reduced medication waste. Seventy-four percent reported use of PFS increased confidence in the integrity of preparations. Additionally, 90% agreed that the use of PFS saved them time in preparing for surgical procedures when compared to using vials and sixty-eight percent reported a 3 to 6 minute time savings. Respondents believed that the largest waste reduction was seen with the use of succinylcholine (18 comments) followed by atropine (13 comments), glycopyrrolate (12 comments), and other (13 comments). Among the benefits of the use of PFS, labeling (22 respondents) was rated as highest of importance followed by more time spent with patients (11 responses), workflow efficiencies gained with room set up time (18 responses), and that PFS were helpful in improving patient safety (10 responses).

DISCUSSION: The use of PFS was viewed favorably by the majority of respondents. Clinician consensus of the benefits of PFS’s was improvements in patient safety, decreased medication waste, and case-preparation time. Limitations to this study are clinicians were not aware of nor responsible for any differences in cost data and the survey was not designed to measure the impact on patient safety. It is clear that clinician acceptance is high and we speculate that through the reduction in human error, either in labeling or drug dilution, patients are safer through the use of PFS, although this must be studied.

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