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Evidence-based Practice and Quality Improvement

Cost implications of wasted emergency drugs


Bramma, Y. L.; Gray, C.; Stewart, L.; Alcorn, D.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 22-22
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Background and Goals: Emergency drugs are commonly drawn up at the start of a list. Most of these drugs are not used and are then discarded at the end of the day, representing a waste of resources at considerable cost. Our aim was to quantify the magnitude and cost of these wasted drugs to our department.

Methods: Emergency drugs were audited across in-patient theatres over a two weeks. Data was collected on drugs drawn up at start of day and drugs discarded at end of day. Cost of individual drugs was obtained from pharmacy. A wasted drug was defined as a drug drawn up from the ampoule but not used. The cost of wasted drugs was calculated and extrapolated over 12 months. The results were presented at our departmental audit meeting and anaesthetists asked to draw up emergency drugs only as needed. The audit was repeated 12 months later and costs calculated again.

Results: Results from both cycles are shown. There was a 51% reduction in the cost of discarded drugs.

[Cycle 1 - Quantity and Costs of Wasted Drugs]
[Cycle 2 - Quantity and Costs of Wasted Drugs]

Discussion: We initially wasted approx £3800pa on wasted emergency drugs. The most viable way for us to reduce these costs without impacting upon patient safety was to draw up drugs only when needed, instead of routinely at the start of a list. The routine use of pre-filled syringes was more expensive than drawing drugs up from the ampoule. However, they remained available for emergency situations where there was not sufficient time to draw a drug up. This approach allowed us to reduce the number of discarded drugs and cut these costs by half.

It is important for us all to be cost aware and consider what drugs we may need to use on a case-by-case basis. These figures represent wasted resources in one hospital alone. If this was extrapolated across the health board, there is potential to make even bigger savings.

© 2013 European Society of Anaesthesiology