Do we waste drugs in theatres?

Aim of audit

Anaesthetic expenses, a small part of hospital expenses.
But, it definitely is an expense.
To find out whether we waste any drugs.
If yes, what are the things we waste?

Methods

A simple audit form, to be filled in by ODPs/ Anaesthetic nurses.
Duration- one month- April, 2005.

Data

Total 32 sessions reported.
Week days- 31, Week ends- 1.
Sessions- Morning 13, Noon 12, Evening 6, Night 1.
Scheduled 21, CEPOD 2, trauma 3, Emergency 6.
Main OT 26, Obstetrics 5.

Results…

Out of 32 sessions-
No wastage 10 sessions.
Wastage on 22 sessions.
The list of drugs opened but not used at all.
Atropine 11, Ephedrine 15.
Thiopentone 5, Propofol 5.
Lignocaine 4.
Antibiotics 1.
Suxamethonium 4, NMDR 3.
Morphine 3, Fentanyl 1.
Midazolam 1.
Phenylephrine 1.

Total…

Percentage…

Timing wise

Conclusion…
Difficult to draw conclusion.
But we definitely waste drugs.
It involves expensive drugs including propofol, NMDR, Morphine, fentanyl.
May be over reported positive finding.
May be just a tip of an iceberg.

Recommendations
Communication- in theatre, recovery?
Labelling
Drawing up of drugs- Morphine, Fentanyl- just before use.
Muscle relaxants, especially NMDRs just before use (more safe!).
Atropine/ ephedrine/ Suxamethonium- pre-filled syringes?
Have you got any solutions? - Discussion.

THANKS