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“A lot of the risk occurs when you go in and out of that vial,” Luebbert says.But healthcare facilities don’t always have that option, and as a result they may have multiple multidose vials available for clinicians.“When we wrote our position paper, our communication indicated that staff was to follow their own hospital policy,” Dolan says.“However, that may not be the case today given conversations I had with colleagues at our recent APIC national conference.Your multidose vial may have an expiration date on the label, but that does not take into consideration the date the vial is first used, which is when the 28-day rule takes effect.In addition, not all medications are alike—some must be used soon after being opened, which requires the manufacturer’s specific recommendations.
“Sometimes it depends on refrigeration, so you need to talk to the manufacturer and get it in writing.” Keep a log When Luebbert consults with facilities on how to handle multidose vials, she recommends developing a log, similar to sharps safety evaluations, so that you can track each medication and provide documentation to a surveyor to prove compliance.
It would be helpful to have one evidence-based recommendation for discarding used multidose vials that healthcare personnel and surveyors can both utilize.” The regulatory perspective On June 9, Joint Commission Online published a clarification on multidose vials, reinforcing the 28-day rule.
MM., element of performance 7, requires facilities to store all medications labeled with an expiration date, which is defined as the last date the product can be used, the clarification says.
Therefore, we are currently having conversations with various organizations to help develop one consistent message for the [healthcare professional].
It appears that the 28-day recommendation will prevail along with ensuring vials are accessed, stored, and utilized properly.” Use the smallest vial possible Luebbert’s first recommendation is to use multidose vials as little as possible to minimize risks and complication.