SURVEY OF WASTAGE FROM INTRAVENOUS ADMIXTURE IN UNITED-STATES HOSPITALS

The purpose of this study was to assess current wastage from intravenous systems designed for intermittent use in US hospitals. Questionnaires were mailed to pharmacy directors at 1393 randomly selected hospitals. Respondents were asked to indicate their overall percentage intravenous wastage rate, intravenous admixture policies and procedures, and wastage rates for currently used intermittent intravenous drug delivery systems. If actual data were not available, respondents were asked to provide estimates based on their perceptions of waste. A total of 237 (17.0%) usable responses were returned. The mean intravenous wastage was 2.85% (+/- 3.40) for respondents who provided actual values and 4.28% (+/- 3.83) for respondents who provided estimated values. Lower mean wastage rates were found for hospitals which: (a) received written notification of discontinued intravenous systems; (b) had an elapsed time of less-than-or-equal-to 1 hour from discontinuation of the intravenous system to notification in the pharmacy; (c) actively retrieved discontinued intravenous systems from the nursing unit; and (d) had a daily return of discontinued intravenous systems to the pharmacy. Based on actual values provided by respondents, for 9 intravenous systems the mean wastage rates were lowest for commercially prepared intermittent systems such as frozen piggyback systems [1.5% (+/- 1.4)] and piggyback systems stored at room temperature [3.2% (+/- 5.2)), and 4.4% (+/- 16.0) for nursing-activated ADD-Vantage(R) systems. We expected that pharmacy managers would monitor waste regularly and be able to provide actual values for wastage rates. However, only 124 (53.3%) of the respondents provided actual data. Results of a survey of 108 nonrespondents showed that 55.6% indicated that the data were not readily available and would take too long to collect. These results, combined with the low response rate, suggest that intravenous wastage is not monitored on a regular basis by many hospital pharmacy departments.