Jenny Liou1, Kurt Clyne1, Donnet Knapp2, Jay Snyder3. 1. Pharmacist, Saint Elizabeth Regional Medical Center , Lincoln, Nebraska . 2. Microbiology Team Lead, Saint Elizabeth Regional Medical Center , Lincoln, Nebraska . 3. Director of Cardiopulmonary, Saint Elizabeth Regional Medical Center , Lincoln, Nebraska .
Abstract
BACKGROUND: Recycling metered-dose inhalers (MDIs) is an effective method to conserve medications resulting in significant cost savings to the hospital. A noted limitation in some reports is the potential for cross-contamination. OBJECTIVE: To implement a quality control program to monitor and validate the safety of recycled MDIs for institutional reuse. METHODS: A quality control program was conducted from December 2012 to May 2013. At a 257-bed acute care facility, MDIs are administered to a single patient using a patient-specific valved holding chamber and then returned to the pharmacy for cleaning with 70% isopropyl alcohol prior to re-dispensing to a new patient. Ten percent of MDIs from 3 categories were categorized: prior to pharmacy cleaning, after pharmacy cleaning, and new/unused control group each month. The mouthpiece and canister spray tip from each MDI were tested. Any bacterial growth was documented. A secondary test was conducted to ensure that artificially contaminated MDIs could be cleaned with current cleaning procedures. Cost savings measures were also quantified. RESULTS: There was no bacterial growth on the 17 recycled MDIs cultured prior to the cleaning process. Bacteria did not grow on any of the 33 recycled MDIs cleaned with 70% isopropyl alcohol. Likewise, in the control group of 33 new/unused control MDIs, there was no bacterial growth. No bacteria growth was found after cleaning each artificially contaminated MDI. Total drug cost savings during the study period was approximately $130,000. CONCLUSIONS: Establishing a strict quality control program is paramount to validating a safe and effective recycled MDI procedure.
BACKGROUND: Recycling metered-dose inhalers (MDIs) is an effective method to conserve medications resulting in significant cost savings to the hospital. A noted limitation in some reports is the potential for cross-contamination. OBJECTIVE: To implement a quality control program to monitor and validate the safety of recycled MDIs for institutional reuse. METHODS: A quality control program was conducted from December 2012 to May 2013. At a 257-bed acute care facility, MDIs are administered to a single patient using a patient-specific valved holding chamber and then returned to the pharmacy for cleaning with 70% isopropyl alcohol prior to re-dispensing to a new patient. Ten percent of MDIs from 3 categories were categorized: prior to pharmacy cleaning, after pharmacy cleaning, and new/unused control group each month. The mouthpiece and canister spray tip from each MDI were tested. Any bacterial growth was documented. A secondary test was conducted to ensure that artificially contaminated MDIs could be cleaned with current cleaning procedures. Cost savings measures were also quantified. RESULTS: There was no bacterial growth on the 17 recycled MDIs cultured prior to the cleaning process. Bacteria did not grow on any of the 33 recycled MDIs cleaned with 70% isopropyl alcohol. Likewise, in the control group of 33 new/unused control MDIs, there was no bacterial growth. No bacteria growth was found after cleaning each artificially contaminated MDI. Total drug cost savings during the study period was approximately $130,000. CONCLUSIONS: Establishing a strict quality control program is paramount to validating a safe and effective recycled MDI procedure.
Entities:
Keywords:
cost savings; hospital pharmacy service; metered-dose inhalers; quality control