Single-Use Vials: Safety, Cost, and Availability

Laura A. Stokowski, RN, MS


August 02, 2012

In This Article

Reusing Healthcare

The problem of reuse of single-use medical items and devices is not new. Almost as soon as healthcare began adopting single-use and disposable items in the 1970s for purposes of infection control, the reuse of such items began as a cost-saving measure. Despite infection control guidance to the contrary, in 2008, 20%-30% of US hospitals reported that they reused at least 1 type of single-use device.[1]

Evidence suggests that reuse practices extend to sterile vials of injectable drugs intended for one-time use. For example, some nurses and other healthcare providers admit to practices such as re-entering single-dose/single-use sterile vials after the initial access, either for the same or different patients, or inappropriately diluting contents of single-dose vials. A 2012 online survey[2] of 5446 healthcare practitioners found that 6% of respondents sometimes or always used single-dose/single-use vials for multiple patients, 15% used the same syringe to re-enter multidose vials, and 9% sometimes or always used a common bag or bottle of intravenous solution as a source of flushes and drug diluents for multiple patients. Comments made by respondents suggest that healthcare practitioners have many misconceptions about injection safety with single-use vials.

Why would educated healthcare professionals, committed to patient safety, do such a thing? The reasons are many. Efficiency, time constraints, conservation of resources, avoidance of waste, and cost considerations have all been cited to rationalize the misuse of single-dose vials. Of significance, however, most healthcare professionals who regularly use single-use vials inappropriately don't fully realize how dangerous it is to do so. If aseptic technique is maintained, they reason, what's the problem?


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