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Three tips to ensure multi-dose vial safety

Ambulatory Safety Monitor, April 22, 2004

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Using one multi-dose vial of medication for several patients is a fairly common practice, but how do you make sure the medicine doesn't expire or become contaminated?

You need to have a good multi-dose vial policy that will work well within your organization, says Winston Fuller, PharmD, staff pharmacist at the University of California Davis Medical Center in Sacramento. Research current data about infection control and safe medication use for your policies.

Fuller and his staff do the following to ensure the safety of multi-dose vials:
*  They inspect all vials and their expiration dates every month. Most multi-dose vials are safe until the manufacturer's expiration date printed on the vial.
*  They examine all vials for cracks in the stoppers, precipitation in the vial, and any abnormal appearance in the medicine during monthly inspections. Fuller discards any vials that have problems.
*  They also check the vials every time a patient receives medicine. If the vials are not perfect, the staff member will discard it.

Here are some guidelines you can consider when creating a multi-dose vial policy:
*  Develop a list of medications (i.e., types of insulin) in which the expiration dates change once you open the vial.
*  Whenever staff open a new vial of medication on that list, they label the vial with the date they opened it. Follow the manufacturer's recommendations to discard these vials.
*  Store open vials in lockable refrigerators unless the manufacturer recommends otherwise.

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