Reducing waste of intravenous solutions

Area of Science:

• Pharmacy Practice
• Healthcare Management
• Drug Compounding

Background:

• Intravenous (IV) drug solutions are essential in acute care but contribute to pharmaceutical waste.
• Minimizing waste is crucial for cost-effectiveness and resource optimization in healthcare settings.

Purpose of the Study:

• To present a comprehensive program designed to reduce the waste of IV drug solutions.
• To evaluate the effectiveness of implemented waste reduction strategies through audits.

Main Methods:

• Implementation of a multi-faceted waste reduction program including shift-based compounding, solution recycling, and standardized administration.
• Utilizing automatic stop orders, standardized total parenteral nutrition (TPN) solutions, and commercial product utilization.
• Conducting six 30-day audits over three years (1987-1990) to quantify discarded IV admixtures.

Main Results:

• The hospital achieved an average IV solution waste rate of 3.27%, significantly lower than reported benchmarks.
• Major sources of waste identified were dosage adjustments, STAT drug orders, and poor pharmacy-nursing communication.
• Intensive care units, pediatrics, and general medicine wards were primary contributors to waste.

Conclusions:

• The implemented program effectively minimized IV drug solution waste to a low rate.
• Areas for further improvement include enhancing physician access to IV solution formulas and expanding standardized TPN solutions.
• Strengthening communication between pharmacy and nursing units is vital for continued waste reduction.