Testing and Materials International. The label makers can be pre-
programmed with the common procedure types for your ORs. Once
you pick the procedure, the machines print out labels for the med-
ications the anesthetist uses for those cases. The fields on the labels
are prefilled, so the anesthetist simply affixes the labels to the meds
as they're prepped. These label makers are stand-alone or can be
integrated with an EMR.
5. Prefilled syringes
The AORN Guideline for Medication Safety recommends using pre-
filled syringes if they are available to make sure you're giving
patients the proper dose of medication in a way that reduces the
risks of cross-contamination, says Mr. Burlingame. However, a ISMP
survey conducted in 2012 discovered that many nurses were remov-
ing the adapters on cartridge-type prefilled syringes or removing the
cartridge all together to withdraw the medication through the rub-
ber diaphragm. There were many stated reasons for their misuse of
the safety-engineered devices, such as a lack of available syringe hold-
ers, being unable to see the volume markings on the prefilled syringe
or wanting to dilute the medications for various reasons before
administering them to patients. According to the ISMP's Safe Practice
Guidelines for Adult IV Push Medications, withdrawing medications
from a prefilled syringe could lead to contamination, dosing errors
and drug mix-ups. It's best to avoid this practice.
There are also concerns with the labeling of prefilled syringes. ISMP
recently detailed reports of non-standard labeling and look-alike pre-
filled syringes. Drugs that are compounded or repackaged by pharma-
cies or outsourcing facilities are not held to the same labeling stan-
dards as FDA-approved products. Other compounders may use the
same tamper-proof cap colors and syringe sizes for completely differ-
9 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 8
