Amount of drug discarded within administration sets post infusion

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Safety IV catheter

The aim of this study was to quantify frequency, volume and dose of drug discarded within administration sets in the clinical setting” Cooper et al (2018).

Abstract:

BACKGROUND: intravenous (IV) drugs are administered widely and under-dosing can result in therapy failure. The aim of this study was to quantify frequency, volume and dose of drug discarded within administration sets in the clinical setting.

METHODS: residual volume for 24 different administration sets was measured under controlled conditions in a laboratory. Clinical assessment of current practice regarding post-infusion flushing occurred in 6 departments of one teaching hospital in the UK over 7 days. Details of drug last infused, (concentration, diluent and volume) and type and brand of administration set were collected.

RESULTS: 74% of administration sets were not flushed. Non-flushing exceeded 90% and 61% for gravity and pump infusions respectively (p<0.001) in all areas excluding oncology. Oncology was the only area where flushing was standard practice for all infusions (p<0.001). Mean residual volume of the administration sets was 13.1 ml and 16.7 ml for gravity and pump sets respectively. Antibiotics were commonly infused and up to 21% of antibiotic dose was frequently discarded.

CONCLUSIONS: the findings suggest disposal of substantial volumes of drugs occurs frequently in general hospital areas. Without clear national and local policies this unrecognised under-dosing will continue.



Reference:

Cooper, D.M., Rassam, T. and Mellor, A. (2018) Non-flushing of IV administration sets: an under-recognised under-dosing risk. British Journal of Nursing. 27(14), p.S4-S12.

doi: 10.12968/bjon.2018.27.14.S4.

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