As healthcare costs continue to rise, it is essential to limit medication waste and workforce time waste whenever and wherever possible.1 We’re committed to helping.
Welcome to the Waste Reduction Toolkit, a dedicated resource designed to enhance cross-functional understanding of how controlled substance waste reduction can support operational efficiencies and cost savings within your institution.
In this toolkit, you’ll find support materials and data visualization tools focused on the significant benefits of adopting ready-to-administer (RTA) syringe systems. These resources allow you to review real-life impact data from other institutions or input your own data, offering clear insights into potential savings in medication waste, reduced diversion risk, and improved time management.
The toolkit is organized into two main sections:
Support Materials: Download informational support materials in a PowerPoint format, tailored to facilitate discussions and showcase potential improvements.
Analysis Tools: Assess the impact of switching to RTA syringes by reviewing data examples or entering Automated Dispensing System (ADS) data to visualize waste reduction benefits.
This toolkit will be instrumental in aligning key stakeholders, enabling them to evaluate institutional data and establish actionable steps to quantify and mitigate medication waste collaboratively. It supports informed decision-making and fosters collaboration across departments for a streamlined and more efficient healthcare environment.
If you have any questions along your journey, please contact us.
References: 1. Hertig JB, Degnan DD, Scott CR, Lenz JR, Li X, Anderson CM. A comparison of error rates between intravenous push methods: a prospective, multisite, observational study [published online ahead of print September 8, 2017]. J Patient Saf. doi:10.1097/PTS.0000000000000419.
Optimization
Reduce waste with product size optimization
Simplist® ready-to-administer prefilled syringe presentations that more closely align with commonly ordered doses help reduce the need to waste excess medication.
Illustration above is for demonstration purposes only and not representative of all vial and syringes size.
Introduction to Simplist
Simplist® ready-to-administer prefilled syringes are single-unit dose prefilled syringes that require no assembly at the point of care.
Designed for efficient medication delivery and ease of use, Simplist helps reduce waste potential and eliminate steps where errors can occur.1,2
References: 1. Fanikos J, Burger M, Canada T. An assessment of currently available i.v. push medication delivery systems. Am J Health Syst Pharm. 2017;74(9):e230-e235. 2. Hertig J, Jarrell K, Arora P, et al. A continuous observation workflow time study to assess intravenous push waste. Hosp Pharm. 2021;56(5):584-591
Benefits
Ready-to-administer delivery system benefits1
Fewer steps and manipulations with no dilution required, minimizing contamination and limiting the opportunities for medication errors1,2
Labeled and barcoded to help bedside verification of proper drug and dose prior to administration, promoting safe medication delivery1
Improved standardization may reduce training requirements for medication administration and variability in administration practices1,2
Time savings and improved workflow for nurses1
References: 1. Fanikos J, Burger M, Canada T. An assessment of currently available i.v. push medication delivery systems. Am J Health Syst Pharm. 2017;74(9):e230-e235. 2. Institute for Safe Medicine Practices. Safe Practice Guidelines for Adult IV Push Medications. Accessed June 23, 2022.
Primary Literature: A Comparison of Error Rates Between Intravenous Push Methods: A Prospective, Multisite, Observational Study
Simplist® is associated with a 4x lower error rate compared to traditional practice including cartridge-based systems1
A prospective, multisite, observational study of IV push medication preparation and administration compared the error rates between ready-to-administer products and traditional practice, including a cartridge-based syringe system and vial and syringe.
References: 1. Hertig JB, Degnan DD, Scott CR, Lenz JR, Li X, Anderson CM. A comparison of error rates between intravenous push methods: a prospective, multisite, observational study [published online ahead of print September 8, 2017]. J Patient Saf. doi:10.1097/PTS.0000000000000419.
Primary Literature > A Continuous Observation Workflow Time Study to Assess Intravenous Push Waste
There are significant financial costs associated with waste
Product
$2.40
Average total cost per dose wasted for all medications
Workforce Time
2 hours, 4 minutes, 52 seconds
Average time to chart product waste
Delays in proper documentation put the patient, nurse, and organization at risk
Product size should be optimized by matching availability with practical use
Most frequently observed waste amounts for fentanyl and hydromorphone
|
Drug |
Strength |
Fill Volume |
Waste Amount |
Total Waste* |
|
Fentanyl |
100 mcg per 2 mL |
2 mL |
50 mcg |
50% |
|
Fentanyl |
100 mcg per 2 mL |
2 mL |
75 mcg |
46% |
|
Hydromorphone |
1 mg per 1 mL |
1 mL |
0.5 mcg |
63% |
|
Hydromorphone |
1 mg per 1 mL |
1 mL |
0.8 mcg |
18% |
References: 1. Hertig, J., Jarrell, K., Arora, P., Nwabueze, J., Moureaud, C., Degnan, D. D., & Trujillo, T. (2020). A Continuous Observation Workflow Time Study to Assess Intravenous Push Waste. Hospital Pharmacy.
*Percentages are rounded to nearest whole number.
Primary Literature > A Cost-Effectiveness Study Comparing Ready-to-Administer and Traditional Vial-and-Syringe Method for Opioids
Simplist® is associated with a 94% reduction in errors compared with the traditional vial-and-syringe IV push method.
The analysis was conducted from a health system, focusing only on inpatient units, using a model designed from a time horizon of one year with a sample size of 15,727 administrations.
Simplist RTA prefilled syringes vs. Traditional vial-and-syringe
$182.61
Estimated savings per administration
$22,554
Incremental savings per additional error avoided
$2,871,889.27
Annual savings
References: 1. Arora, P., Muehrcke, M., & Hertig, J. (2022). A Cost-Effectiveness Study Comparing Ready-to-Administer and Traditional Vial-and-Syringe Method for Opioids.
Primary Literature > Intraoperative Opioid Waste and Association of Intraoperative Opioid Dose with Postoperative Adverse Outcomes: A Hospital Registry Study
Higher doses of controlled substances are associated with a higher risk of patient harm.
This study observed a total of 170,607 patients who underwent general anesthesia and received intraoperative fentanyl, morphine, or hydromorphone.
Post-procedural Category E adverse events observed*
19,916
Fentanyl
1,500
Morhpine
14,332
Hydromorphone
*Post-extubation desaturation, postoperative nausea and vomiting needing rescue treatment in the PACU, or postoperative somnolence or sedation needing nursing observation or administration of naloxone.
References: 1. Redaelli, S., Suleiman, A., von Wedel, D., Ashrafian, S., Munoz-Acuna, R., Chen, G., Khany, M., Stewart, C., Ratajczak, N., Hertig, J., Nabel, S., Schaefer, M. S., & Ramachandran, S. K. (2023). Intraoperative Opioid Waste and Association of Intraoperative Opioid Dose with Postoperative Adverse Outcomes: A Hospital Registry Study.
Evaluation and Implementation Timeline
Example timeline for identifying institutional waste activities and implementing Simplist ready-to-administer syringes.
FK Pharmacy Analytics team reviews current waste analysis process
Automated dispensing systems reports sent to FK Pharmacy Analytics team
Pharmacy Analytics team presents overall review
To ensure available supply
Addition of fentanyl 50 mcg/ 1 mL and change to hydromorphone 0.2 mg from 0.25 mg
To change to hydromorphone 0.2 mg default Fentanyl 50 mcg / 1 ml added to radiology & anesthesia carts
To nursing units, ED, and Cath lab
Hydromorphone 0.2 mg Injection as default dose change and Hydromorphone 0.2 mg Injection addition
Hydromorphone 0.2 mg Injection and Fentanyl 50 mcg/mL stocked
Fentanyl 100 mcg / 2 mL unloaded from Critical Care area Pyxis
Review of Post go-live reports
* All evaluations and implementation plans are different.
Waste Analysis Data Visualization
Potential Impact
This tool is designed to show the potential impact changing to RTA Syringes can have within an institution.
Fresenius Kabi has help identify the necessary waste data from customers’ automated dispensing systems and helped calculate how much narcotic waste is costing institutions. Below is a summary of average potential reduction in waste events by hospital sizes.*
Select your preferred Hospital size to be included in your Toolkit Download:
Fentanyl
Estimated waste
event transaction
13,644 transactions
Annualized reduction in waste events
289 hours
Estimated annual time saved wasting**
Hydromorphone
Estimated waste
event transaction
21,724 transactions
Annualized reduction in waste events
460 hours
Estimated annual time saved wasting**
Morphine
Estimated waste
event transaction
1,348 transactions
Annualized reduction in waste events
29 hours
Estimated annual time saved wasting**
*Data on file provided by real clients. Hospitals analyzed N = 38, Fentanyl Citrate Injection, USP n = 16, Hydromorphone HCl Injection, USP n = 16, Morphine Sulfate Injection, USP n = 11
**Calculated using workforce time wasted per event of 76.2 seconds in Hertig et al.
Hertig, J. et al. (2020). A continuous Observation Workflow Time Study to Assess Intravenous Push Waste. Hospital Pharmacy.
Fresenius Kabi provides no guarantee of the likelihood that you will achieve similar results if you use our products.
Support Materials Download
Download your Toolkit as a powerpoint presentation with aggregated and anonymized customer data you selected above.
Customize your PowerPoint presentation by adding your institution's data into our waste reduction form.
Customize data
Created for Institution Name
By Firstname Lastname
Fresenius Kabi USA, LLC © 2024. Simplist® is a registered trademark of Fresenius Kabi USA, LLC.
Potential Impact at Institution Name
Fentanyl
Estimated waste
event transaction
13,644 transactions
Annualized reduction in waste events
289 hours
Estimated annual time saved wasting**
Hydromorphone
Estimated waste
event transaction
21,724 transactions
Annualized reduction in waste events
460 hours
Estimated annual time saved wasting**
Morphine
Estimated waste
event transaction
1,348 transactions
Annualized reduction in waste events
29 hours
Estimated annual time saved wasting**
*Calculated using workforce time wasted per event of 76.2 seconds in Hertig et al.
Hertig, J. et al. (2020). A continuous Observation Workflow Time Study to Assess Intravenous Push Waste. Hospital Pharmacy.
Preparing your powerpoint...
