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:
Proper hand hygiene prior to handling the multi-dose, wear appropriate personal protective equipment
Cleanse the rubber septum or needleless device thoroughly with alcohol
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  and the Centers for Disease Control (CDC) recommend:
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
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.