Comparison of seven methods of preparing and administering small-volume injections

The time and costs associated with preparing and administering small-volume injections using seven infusion systems were compared. Thirteen demographically diverse hospitals were chosen as study sites, all under a common protocol. The systems compared were the CRIS controlled-release infusion, minibag, frozen ready-to-use minibag, drug manufacturer-supplied piggyback, syringe pump, volume-control set, and ADD-Vantage systems. Care was taken to ensure that similar drugs (i.e., drugs with equivalent preparation steps) were studied in the same test systems at the hospitals. The mean preparation time for the CRIS controlled-release infusion system was significantly longer than the times for the frozen ready-to-use minibags and ADD-Vantage system and significantly shorter than the times for the minibag and syringe pump systems. Medication administration time for initial doses was found to be significantly shorter with the CRIS system than with the volume-control and ADD-Vantage systems; the time required to administer subsequent doses of small-volume injections was shorter with CRIS than with all other systems except the ADD-Vantage system. When total material costs plus the cost of labor involved in both pharmacy and nursing were combined, CRIS proved to be the least expensive system to use, primarily because of the time and cost savings associated with its use for administration of subsequent doses. Of the seven admixture systems studied, the CRIS system proved to be the least expensive to use when labor and material costs associated with preparation and administration of six doses of an injectable drug were considered.