Evaluation and implementation of strategies to reduce the intravenous admixture returns

Pharmaceutical sterile wastes are not only environmental hazard but an economical loss. There are many strategies employed in various parts of the world for minimizing the parenteral admixture returns in hospitals, however, they are not practiced in Saudi Arabia. Therefore, this study was done to assess the impact of a) intravenous (IV) pharmacy round and b) twice daily batching, as reduction strategies on the number of IV admixture returns and the associated cost of medication wastage.

This study was conducted at the central IV room of the in-patient pharmacy unit at King Fahad Medical City, Riyadh, Saudi Arabia for general intensive care unit (ICU) IV returns. Phase 1 of the study was intended to measure the baseline parameters, while the Phase 2 and 3 were measured with the application of IV pharmacy round plan, and twice-daily batching strategies, respectively. Comparison of IV returns were done in each of the phases and economical loss was calculated.

Out of number of IV admixtures prepared and supplied to ICU during a month, 4.85% of the items were deemed wasted during baseline phase with as estimated cost of IV wasted items to be 2,128.02 USD. In the IV pharmacy round and twice-daily batching strategies, the percentage of the wasted items decreased to 4.27% and 3.73%, respectively. Moreover, there is 13.84% and 42. 48% reduction in the estimated cost in the wasted items in, pharmacy round and twice-daily batching strategies, respectively, compared to baseline phase.

Implementation of interventions caused reduction in total recycled, wasted items and the associated cost of medication wastage of sterile pharmaceutical preparations. Twice daily batching strategy has better effect in decreasing the IV returns and its associated cost.