The current injection safety guidance is part of CDC’s 2007 Guideline Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings.
It is imperative that drug shortages and drug waste concerns are dealt with appropriately and do not lead to unsafe medical practices that impose increased disease risk on patients.
Shortages of some essential medications may warrant implementation of meticulously applied practice and quality standards to subdivide contents of single-dose/single-use vials, as stated in United States Pharmacopeia General Chapter ‹797› Pharmaceutical Compounding – Sterile Preparations.
The most frequent contaminated medication was insulin.
Gram-positive bacteria (81.82%) were more significantly involved than gram-negative ones (9.09%) and fungi (9.09%), with the highest frequency for Our data demonstrate that repeated use of vials especially if basic sterility measures are disobeyed can cause microbial contamination of administered products to the patients.
Dedicating a single-dose/single-use vial to one patient is, in and of itself, a critical element of proper infection control.
CDC continues to see outbreaks in healthcare settings where providers thought they were preparing and administering injections safely.In fact, in one study published in the Journal of the American Medical Association, CDC and Centers for Medicare and Medicaid Services colleagues reported that two-thirds of the outpatient facilities inspected had lapses in basic infection control practices ( Moreover, infection surveillance is lacking in most outpatient settings; thus it is likely that outbreaks are occurring at a higher frequency, but going undetected.CDC’s recommendations regarding single-dose/single-use vials are flexible.Qualified healthcare personnel may repackage medication from a previously unopened single-dose/single-use vial into multiple single-use vehicles (e.g., syringes).This should only be performed under ISO Class 5 conditions in accordance with standards in the United States Pharmacopeia General Chapter 797, Pharmaceutical Compounding – Sterile Preparations, as well as the manufacturer’s recommendations pertaining to safe storage of that medication outside of its original container.The name of the medication, ward, labeling of the vials, the date of opening, and storing temperature were recorded for each vial.