Time and Motion Study Comparing the Preparation of Ampoules Versus Pre-Filled Syringe for Critical Care Drugs

A range of ampoule-based preparations are currently used for intravenous administration in critical care situations.Many of the same drugs can be provided in pre-filled syringes (PFS), which may limit the time lost in diluting or reconstituting treatments, while also minimising potential for dosing errors.We aimed to: (1) determine the average time taken for nurses to prepare a single dose of a range of critical care drugs from an ampoule or prepare a PFS ready for administration; (2) assess the consumable requirements associated with the preparation; and (3) assess the quality of each preparation, noting any preparation errors.Compared with ampoule-based preparations, PFS preparations, which are ready-to-use with no dilution necessary, were found to have a number of benefits: (1) faster to prepare; (2) less potential for injury; (3) fewer spillages; (4) more accurate dosing; (5) easier to handle; (6) fewer preparation errors; (7) fewer consumables used; (8) preferred by nurses.Reported potential drawbacks of the PFS were bulky storage; perceived higher cost; potential for complacency during drug preparation and occasional lack of local availability.Hence, PFS use may be particularly beneficial in the following situations: (1) emergency situations where time is critical; (2) times of high levels of agency nurse usage or when there is a lack of nursing resource to adequately cover the workload; and (3) to mitigate risk in the peri-operative setting.