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

The time and costs of preparing and administering cefazolin sodium small-volume injections using automated and manual systems were compared. Doses of cefazolin sodium 1 g were prepared in batches of 100 using each of seven methods, and preparation and administration times were recorded during five time trials. Personnel time and total material costs were determined. Bulk-vial reconstitution methods included manual piggyback, manual 24-hour piggyback, and manual syringe systems and one automated syringe infusion method (Bard programmable dispensing pump). Three prefilled container systems (Faspak flexible plastic bags, manufacturers' partial-fill glass bottles, and cefazolin sodium 1-g vials reconstituted using the ADS 100 Physio-Control peristaltic pump and administered via the IVAC CRIS system) were compared with each other and with the bulk reconstitution methods. Of the bulk-vial methods, total preparation process times were significantly shorter for the 24-hour piggyback system. Of the prefilled container systems, total preparation process time was significantly shorter for the Faspak system. Total daily administration process time was shortest for the IVAC CRIS system. Material costs per dose were lowest for the IVAC CRIS system and highest for the syringe pump systems (manual syringe and Bard syringe). Although lowest cost per dose was identified with the IVAC CRIS system, the 24-hour piggyback system was the system of choice on the basis of similar cost savings, its ability to manage primary fluids, and practicality of use at this institution.