Why the Utilization of Ready-to-Administer Syringes During High-Stress Situations Is More Important Than Ever.
Pashmina Malik, Melissa Rangel, Tracy VonBriesen
PMID 34839309WHAT IT FOUND
Cited studies report fewer medication errors with ready-to-administer prefilled syringes than bedside preparation.
Nurses should use these forms when available and avoid diluting or transferring them, especially in rushed, high-stress care.
Key findings
01A cited randomized controlled trial reported that bedside preparation could require up to 41 individual steps and took a statistically significant mean time increase of 106 seconds. It also reported that medication error risk was 17 times greater for bedside-prepared medications than for ready-to-administer prefilled syringes.
02A cited prospective multisite observational study reported a 2.5% error rate with manufacturer-prepared ready-to-administer prefilled syringes and a 10.4% error rate with traditional vial and syringe methods. The authors reported this difference as statistically significant.
03An ISMP survey of 997 respondents reported persistent unsafe IV push practices: 84% further diluted IV push medications, including 16% of manufacturer-prepared prefilled syringes; 66% withdrew medication from prefilled syringes or cartridges into another syringe; and 28% rarely or never labeled syringes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The authors state that this review was not intended to answer a specific clinical question. The evidence summarized is variable and includes observational studies, surveys, case reports, and risk analyses. The impact of ready-to-administer syringes during the COVID-19 pandemic was still evolving when the article was written. The consensus panel noted that lack of availability of preferred systems might pose a challenge to adoption. The article recommends further investigations on workflow, cost savings, drug waste, drug diversion, microbial contamination, and medication errors.
The easy way to misread this
Do not read this as a definitive trial showing that ready-to-administer syringes prevent all medication errors in your setting. The article is a narrative review, not an original study, and it says it was not intended to answer a specific clinical question.