(960) Medication Administration Practices and Reduction in Plastic Waste

Introduction: In recent years, there has been more emphasis in evaluating processes for sustainability and efforts toward conservation of supplies and resources within the hospital setting. In addition, disruptions in the supply chain have created additional incentive to reduce waste and conserve limited resources. Numerous intravenous (IV) medications are administered by a variety of methods, including IV piggyback (IVPB) and IV push (IVP). Certain medication administration methods, may require additional materials (e.g. IV tubing sets). Depending on the manufacturer, these products contain PVC/DEHP which contribute to plastic waste generation We hypothesized that conservation and sustainability efforts could be further streamlined with IVP administration.

Methods: A review of the administration methods of antibiotics commonly used were evaluated for IVP administration. We retrospectively evaluated average number of antibiotic doses administered over a 6- month period that qualified for IVP administration. With this information, we calculated total cost of the administration of each dose and the plastic waste associated with each administration. This included all materials associated with administration for the two methods. IVPB requires the diluent bag (sodium chloride or dextrose), vial adapter device, and secondary tubing while IVP requires the use of a syringe, sterile water for injection, needle, etc.

Results: In comparing the total cost of the ancillary supplies for administration of IVPB versus IVP, our institution found the cost to be $5.27 per dose with IVPB administration versus $1.51 per dose with IVP administration. The total plastic waste was found to be 78.73 grams for IVPB versus 34.75 grams for IVP administration. We estimated ~5,000 doses of antibiotics per month would qualify for a conversion. This would be an estimated savings $18,850 and 220 kg of waste avoidance or approximately $225,000 and 2,600 kg annually.

Conclusions: Compared to IVPB administration, IVP administration would reduce overall plastic waste and cost of administration of antibiotics that are already approved for IVP administration. Safety of each administration technique, nursing time and costs for each institution should be further evaluated.