New AORN recommendations include discontinuing the use of multidose vials

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Intravenous news: Infection Control Today report “Following months of research and evaluation, the Association of periOperative Registered Nurses (AORN) has released “Recommended practices for medication safety. Available in the association‟s newly released 2012 edition of Perioperative Standards and Recommended Practices, the medication safety recommended practice (RP) supports positive outcomes and quality patient care before, during and after surgery.

Medication safety has become increasingly important as state and federal inspections are focusing on safe injection practices and accreditation organizations focus on national goals aimed at reducing medication errors. In the past, perioperative nurses may have watched closely for errors while medications are being administered. But the 2005 MEDMARX® Data Report revealed that errors at the point of care often stem from mistakes that took place earlier in the medication use process.

Recommended practices for medication safety outlines best practices for all six phases of medication use: Procuring, prescribing, transcribing, dispensing, administering and monitoring.

As with all published AORN RPs, the medication safety review process included a 30-day public comment period, at which time comments were submitted by perioperative nurses from across the United States, as well as representatives from ANA, ASA, AANA, the FDA, and the Institute for Safe Medication Practices (ISMP). The new RP includes a multidisciplinary approach and can be used by all members of the perioperative team in all perioperative practice settings.

This medication safety RP expands the description of medication safety by looking at broader risk points in the „life‟ of a medication from the point of storage through to the point of disposal of the medication after it has been given,” says Bonnie Denholm, MS, BSN, RN, CNOR, AORN perioperative nursing specialist and lead author of the RP.

According to Ramona Conner, MSN, RN, CNOR, manager of AORN’s standards and recommended practices, the recommendation that intravenous solution containers be punctured as close as possible to time of use is controversial because it may impact efficiency. She also anticipates that some OR personnel may disagree with the recommendation against the use of multidose vials because they are a cost-saving measure, but with the new RP, evidence indicates they pose a risk of cross contamination.”

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