Drug and Material Wastage in Anesthesia Care

In a time of escalating costs for patients and hospitals, waste-reduction strategies in healthcare are increasingly relevant and worthy of consideration. Within anesthesia departments, a significant portion of the operating budget is devoted to pharmaceuticals; wastage of anesthesia drugs is common and a possible target for cost-reduction strategies (Weinger, 2001). Targeting drug wastage is particularly attractive since these protocols would not limit specific drug selection by anesthesia providers (Gillerman & Browning, 2000). Although waste in drug administration could be the result of the difficulties associated with anticipating variations in patient responses, waste-reduction strategies may reduce cost without substantial effects on patient outcomes (Weinger, 2001). It may be possible to estimate rational amounts of drugs needed before a procedure while better preserving unused drugs under optimal and sterile conditions (NavaOcampo, Alarcón-Almanza, Moyao-García, RamírezMora, & Salmerón, 2004). Wastage is particularly prevalent with intravenous drugs due to the fact that these drugs, as opposed to inhaled anesthetic agents, are packaged in discreet amounts (Smith, 2003). Due to concerns about infection control, partially used ampoules and syringes are discarded at the end of a procedure. Unused syringes are frequently discarded as well. For the purposes of the study, drug wastage refers to drugs in syringes, ampoules, or IV bags that have not been fully used yet cannot be reused due to expiration or contamination concerns. This study also considers the wastage of unused materials that are discarded due to safety concerns. In particular, the study focuses on arterial lines, hot lines, laryngeal masks, oropharyngeal and nasopharyngeal airways (OPAs and NPAs), and endotracheal (ET) tubes. Past studies focusing on anesthesia wastage measured drug waste by recording unused or partially used drugs that were discarded at the end of the workday (Weinger, 2001) or indirectly by analyzing hospital records (Gillerman & Browning, 2000). The present study sought to supplement the results of these studies by measuring the drugs and unused materials discarded directly after cases. By surveying the entire anesthesia workplace – including the trash container – the study aimed to comprehensively measure drug and material wastage during anesthesia care in the operating rooms of one teaching hospital.