Evaluating medication waste attributable to lack of proper flushing of intravenous administration sets

Background: Failure to flush IV administration sets after intermittent infusions leaves residual drug volumes, causing underdosing and financial waste. This is particularly critical in intensive care units (ICUs), where precise dosing is essential. Aim: To quantify medication and cost losses from non-flushing practices in a UK ICU. Methods: An observational quality improvement study in a 23-bed ICU analysed residual volumes in used IV sets. Drug type, volume and cost data were recorded and analysed descriptively. Findings: Of 163 sets, 129 were eligible. None were flushed, giving a 100% non-flushing rate. Residual volumes averaged 20.8 ml. Dose losses ranged from 8.3% to 23.2%. Wasted cost per dose ranged from £0.15 to £11.28. Conclusion: Non-flushing of IV administration sets in the ICU is a pervasive source of underdosing and drug waste. The practice compromises antimicrobial stewardship, prolongs illness and erodes healthcare resources. Standardised flushing protocols are urgently needed to ensure patients receive full prescribed doses.