Administering parenteral medications has become routine for nurses across the healthcare spectrum. Subcutaneous, intramuscular, intravenous, or intradermal routes all provide medications in a specific manner. These medications are dispensed in vials, some of which are single use, others multi-dose.
Single dose vials are just that-medication for one-time-use on one patient. Use the medication; then appropriately discard the vial. Multi-dose vials are different; they contain several doses of medication. The manufacturer’s label indicates the amount of medication in the vial and the expiration date. Anti-microbial preservatives are added to prevent the growth of bacteria (but not viruses), which allows the medication to remain safe for several days. Multi-dose vials are designed for the administration of several doses for one patient. If a multi-dose vial is used on more than one patient (for example: TB skin test solution and infl uenza vaccine ), the vial should not be kept or accessed in the immediate patient area, such as patient rooms or treatment rooms. If a multi-dose vial does enter a patient treatment area, it should be designated for that patient only or discarded.
Maintaining aseptic technique is extremely important when handling multi-dose vials:
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Proper hand hygiene prior to handling the multi-dose, wear appropriate personal protective equipment
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Cleanse the rubber septum or needleless device thoroughly with alcohol
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Use a sterile syringe/needle to draw up the solution in a specified clean area. Using the same syringe or needle to draw up more than one dose greatly increases the potential spread of infection Once a needle and/or syringe have been used, they are considered contaminated and must be disposed of in appropriate punctureresistant waste receptacles
United States Pharmacopeia (USP) General Chapter 797 [16] and the Centers for Disease Control (CDC) recommend:
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If a multi-dose vial has been opened or accessed, the vial should be dated and discarded within 28 days unless the manufacturer specifi es a different (longer or shorter) date for that specifi c medication
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If a multi-dose vial has NOT been opened or accessed, it should be discarded according to the manufacturer's expiration date Check with your consultant pharmacist or technician for a list of expiration dates for commonly used multi-dose vials. For more information, visit the CDC at www.cdc.gov.
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