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Multi dose vials of ventolin

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  • #72431
    Giulietta Pontivivo
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    Giulietta Pontivivo

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    Hi lung function units
    Could I ask how other facilities with lung function test centre manage the use of multi dose ventolin inhalers where the patient only gets one single dose via spacer re-use inhalers for multiple patients. The spacers are single use but the ventolin is multi dose use.
    I think the risk is low but the new disposable spaces do not have a large dead space and wonder if other think this could be a risk.
    Many thanks for your support
    Giulietta Pontivivo CICP RN/RM/MPH| CNC/NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
    Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.au

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    #72433
    Helen Truscott
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    Helen Truscott

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    Hi Giulietta,
    I would be interested in learning more about our risks too as we are using the cardboard spacers for our recruit medicals , although these individuals are usually fit and healthy, I guess the risk is fairly low.
    Not sure if we should be ordering a fresh container of ventolin for each user , (which may be more costly , especially if the applicant is no longer using Ventolin at home ), or should we be using a washable spacer ?

    Many thanks for raising this .

    Regards
    Helen
    Helen Truscott RN, RM, MPH
    Team Leader-Health and Medical
    Health & Safety Branch

    [Fire & Rescue NSW]

    Hi lung function units
    Could I ask how other facilities with lung function test centre manage the use of multi dose ventolin inhalers where the patient only gets one single dose via spacer re-use inhalers for multiple patients. The spacers are single use but the ventolin is multi dose use.
    I think the risk is low but the new disposable spaces do not have a large dead space and wonder if other think this could be a risk.
    Many thanks for your support
    Giulietta Pontivivo CICP RN/RM/MPH| CNC/NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
    Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.au

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    #72441
    Meryl Jones
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    Meryl Jones

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    Hi Giulietta,

    I asked the same question but relating to a different setting (paediatric emergency department) a while back and received some useful advice from contributors.
    Not all of our patients prescribed a salbutamol inhaler in the ED actually took one home with them, so we had the similar issue of single-use spacers but staff reusing inhalers in order to save costs.
    I found the following article very useful although again, I acknowledge that it is written about patients admitted to hospital with an acute illness, rather than in the ambulatory/ outpatient setting so may not be relevant to your practice.
    Larson, T., Gudavalli, R., Prater, D., & Sutton, S. (2015). Critical analysis of common canister programs: a review of cross-functional considerations and health system economics. Current Medical Research & Opinion, 31(4), 853-860.
    http://informahealthcare.com/doi/pdf/10.1185/03007995.2015.1016604 Again, this

    Following discussion between clinicians and pharmacists, we decided upon the following approach:

    * It has been assumed that for our organisation, the chance of busy clinicians cleaning MDIs as per evidence-based guidelines is not reliable and the cost of cleaning outweighs the cost of throwing them away. Therefore, MDIs will be used as single-patient items: once issued, they will stay with children for the duration of their inpatient care.

    * All MDIs will have labels attached to them in pharmacy to allow clinicians to add the appropriate information to them (i.e. patient name, dose) so that they can be taken home as discharge medications if required.

    * Any MDI used during hospital stay but not required on discharge will be disposed of.

    * Doctors will be advised to consider good stewardship when prescribing drugs to be taken via MDI to try and rationalise their use (e.g. not prescribing them on a “try it and see” basis to children who are probably too physiologically undeveloped to respond to salbutamol).

    We decided that the cost of the salbutamol MDIs is small (approx. $3), but the risk of spreading infection (since many of our children who are prescribed drugs via MDI have respiratory viruses) is greater. Is your patient cohort relatively “bug-free”? I assume that they may not necessarily have respiratory viruses that cause acute illness, but are they a cohort who are susceptible to harbouring MROs in their sputum?

    Kind regards,

    Meryl

    Meryl Jones
    Clinical Nurse
    Infection Management and Prevention Service

    Children’s Health Queensland Hospital and Health Service
    Level 12
    Lady Cilento Children’s Hospital, South Brisbane QLD 4101

    T: 07 3068 4145.
    E: meryl.jones@health.qld.gov.au
    W: http://www.childrens.health.qld.gov.au
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    Hi lung function units
    Could I ask how other facilities with lung function test centre manage the use of multi dose ventolin inhalers where the patient only gets one single dose via spacer re-use inhalers for multiple patients. The spacers are single use but the ventolin is multi dose use.
    I think the risk is low but the new disposable spaces do not have a large dead space and wonder if other think this could be a risk.
    Many thanks for your support
    Giulietta Pontivivo CICP RN/RM/MPH| CNC/NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
    Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.au

    ______________________________________________________________________
    For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the “svha.org.au” domain (or any other domain of St Vincent’s Health Australia Limited or any of its related bodies corporate) (an “SVHA Email Address”) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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