The following are 13 tips for safe and appropriate use of single-dose and multiple-dose vials for injected medication from The Joint Commission's recent sentinel alert on the subject:
1. Discard any vial if its sterility is in question or has been compromised, even if it is unused or unopened.
2. Reduce waste through selecting the smallest vial necessary when making purchasing and treatment decisions.
For single-dose/single-use vials:
3. Use a single-dose/single-use vial for a single patient during the course of a single procedure. Discard the vial after this single use.
4. If a single-dose/single-use vial must be entered more than once during a single procedure for a single patient to achieve safe and accurate titration of dosage, use a new needle and new syringe for each entry, observing the window of time for which the vial may be left open and used.
5. Do not combine or pool leftover contents of single-dose/single-use vials. Do not store used single-dose/single-use vials for later use, no matter what the size of the vial.
7. Unopened single-dose/single-use vials may be repackaged into multiple single-dose/single-use containers by qualified personnel.
For multiple-use vials:
8. Only vials clearly labeled by the manufacturer for multiple dose use can be used more than once.
9. To reduce contamination risk, limit the use of a multiple-dose vial to only a single patient, whenever possible.
10. When multiple-dose vials are used more than once, use a new needle and new syringe for each entry. Do not leave needles or other objects in vial entry diaphragms between uses, as this may contaminate the vial's contents.
11. Disinfect the vial's rubber septum before piercing by wiping with an approved antiseptic swab. Allow the septum to dry before inserting a needle or other device into the vial.
12. Once a multiple-dose vial is punctured, it should be assigned a "beyond-use" date for 28 days after puncture, unless otherwise specified by the manufacturer.
13. Store multiple-dose vials outside the immediate patient treatment area as per the manufacturer's storage recommendations.
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1. Discard any vial if its sterility is in question or has been compromised, even if it is unused or unopened.
2. Reduce waste through selecting the smallest vial necessary when making purchasing and treatment decisions.
For single-dose/single-use vials:
3. Use a single-dose/single-use vial for a single patient during the course of a single procedure. Discard the vial after this single use.
4. If a single-dose/single-use vial must be entered more than once during a single procedure for a single patient to achieve safe and accurate titration of dosage, use a new needle and new syringe for each entry, observing the window of time for which the vial may be left open and used.
5. Do not combine or pool leftover contents of single-dose/single-use vials. Do not store used single-dose/single-use vials for later use, no matter what the size of the vial.
7. Unopened single-dose/single-use vials may be repackaged into multiple single-dose/single-use containers by qualified personnel.
For multiple-use vials:
8. Only vials clearly labeled by the manufacturer for multiple dose use can be used more than once.
9. To reduce contamination risk, limit the use of a multiple-dose vial to only a single patient, whenever possible.
10. When multiple-dose vials are used more than once, use a new needle and new syringe for each entry. Do not leave needles or other objects in vial entry diaphragms between uses, as this may contaminate the vial's contents.
11. Disinfect the vial's rubber septum before piercing by wiping with an approved antiseptic swab. Allow the septum to dry before inserting a needle or other device into the vial.
12. Once a multiple-dose vial is punctured, it should be assigned a "beyond-use" date for 28 days after puncture, unless otherwise specified by the manufacturer.
13. Store multiple-dose vials outside the immediate patient treatment area as per the manufacturer's storage recommendations.
More Articles on Accreditation:
Sentinel Event Alert: Preventing Infection From Misuse of Vials
5 Top Accreditation Mistakes From AAAHC
AAAHC Collaborates on CMS Panel for PPACA Issues