Critical Care's - Small Change Challenge
This month we carry on with our small change challenge and try to save as little as we can. On your left hand side is our Top 20 medication consumption for last month. Below we share some quick tips to prevent medication wastage 5 Top Tips to Prevent Intravenous Medication Wastage for ICU Nurses During Preparation 1. Verify Orders Before Preparation Double-check active orders in the electronic prescribing system immediately before preparation Confirm administration times to prevent preparing medications too early Communicate with the medical team about any planned medication changes or potential discharge Review the patient's clinical status to ensure IV route is still appropriate 2. Use the Right Vial Size Select appropriate vial sizes that match ordered doses to minimize leftover medication Consider using 500mg paracetamol vials instead of 1000mg when smaller doses are prescribed Check for availability of multiple vial sizes in your medication storage area Report commonly wasted medications to pharmacy for potential stocking adjustments 3. Batch Similar Preparations When Appropriate Coordinate preparation times for patients receiving the same medication Use appropriate batch preparation techniques while maintaining aseptic standards Share resources with neighbouring bed spaces when safe and permitted by policy 4. Know Your Stability Times Be aware of stability data for commonly used IV medications after reconstitution Label all preparations clearly with preparation time, expiry time and your initials Store prepared medications appropriately according to temperature requirements Use medications with shorter stability times first when multiple IVs are due 5. Implement Early IV-to-Oral Conversion Assess swallowing capability daily for all patients on IV medications Initiate IV-to-oral switch discussions during ward rounds Know which medications have excellent oral bioavailability (e.g., paracetamol, fluconazole) Document rationale if IV route needs to be continued despite oral route being available Remember: Every pound saved through reduced medication wastage can be reinvested in patient care. A single 1g IV paracetamol dose costs the NHS approximately £48.30, compared to less than £1 for tablets!
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