Kamal Singh

An audit on the amount of drug wastage and the cost related to the disposal of unused intravenous agents in the operating theatres in a tertiary care hospital

• Authors Details :  
• Thamizhmathi Thangaraju,  
• Reesha Joshi,  
• Harish Kumar Janarthanam,  
• Lakshmi Ramakrishnan

Journal title : Indian Journal of Clinical Anaesthesia

Publisher : IP Innovative Publication Pvt Ltd

Online ISSN : 2394-4994

Page Number : 140-146

Journal volume : 11

Journal issue : 2

116 Views Original Article

Background: This manuscript presents an audit focused on assessing the extent of drug wastage and associated costs linked to the disposal of unused intravenous agents within the operating theatres of a tertiary care hospital. The study aims to carefully look at drug wastage, figure out why it happens, and propose strategies for optimizing resource utilization and cost-efficiency in clinical settings. Materials and Methods: This audit is a prospective observational study carried out in a tertiary care hospital. The amount of drug loaded preoperatively, the amount of drug utilized, the amount of drug unutilized and discarded, the total quantity of drug wasted, and the cost related to the wastage were calculated in percentage. Results: The maximum wastage of loaded drugs was seen with atropine (100%), followed by ephedrine (93.6%), propofol (52.5%), phenylephrine (35.2%), atracurium (28.6%), dexmedetomidine (27.8%), fentanyl (16.8%), vecuronium (16.2%) and morphine (6.4%). The cost analysis revealed that 36.3% of the total loaded drugs were wasted amounting to Rs.46903.54. The cost of wastage of propofol was maximum with Rs.14006 which is 29.8% of total cost wastage followed by atracurium 21%(Rs.9856), dexmedetomidine 18.4%(Rs.8687.5), ephedrine 14.7%(Rs.6919), phenylephrine 10.4%(Rs.4910), fentanyl 3.7%(Rs.1780), atropine 1.9% (Rs.906), vecuronium 1.2% (Rs.563.76), Morphine 0.18% (Rs.85.28). Conclusion: In our audit, the maximum drug wastage was observed with atropine (100%) amounting to Rs.906, and the cost of wastage was maximum with propofol amounting to Rs.14006 which was 29.8% of the total cost of wastage. Our audit underscores the importance of proactive management of drug wastage and disposal costs in healthcare settings, particularly within operating theatres where intravenous agents play a crucial role in patient treatment. By conducting a comprehensive audit and proposing targeted interventions, healthcare institutions can optimize resource utilization, enhance sustainability, and ultimately improve patient outcomes.

Article DOI & Crossmark Data

DOI : https://doi.org/10.18231/j.ijca.2024.030

Article Subject Details

• Anaesthesia pain
• Anaesthesia practice

Article Keywords Details

• Audit.
• Drug wastage
• General anaesthesia
• Operation theatre
• Wastage cost
• Intravenous agents

Article File

Full Text PDF

Article References

• (1). Chaudhary K, Garg R, Bhalotra AR, Anand R, Girdhar K, Anesthetic Drug Wastage in the Operation Room: A Cause for Concern.J Anaesthesiol Clin Pharmacol 2012;28(1):56-61
• (2). Rinehardt EK, Sivarajan M, Costs and Wastes in Anesthesia Care.Curr Opin Anaesthesiol 2012;25(2):221-5
• (3). Kaniyil S, Krishnadas A, Parathody AK, Ramadas KT, Financial Implications of Intravenous Anesthetic Drug Wastage in Operation Room.Anesth Essays Res 2017;11(2):304-8
• (4). Mankes RF, Propofol wastage in anesthesia.Anesth Analg 2012;114(5):1091-2
• (5). Norman GAV, Jackson S, The Anesthesiologist and Global Climate Change: An Ethical Obligation to Act.Curr Opin Anaesthesiol 2020;33(4):577-53
• (6). Hakimoglu S, Hanc? V, Karc?oglu M, Tuzcu K, Davarc? I, Kiraz HA, Cost-Conscious of Anesthesia Physicians: An Awareness Survey.Pak J Med Sci 2015;31(5):1089-94
• (7). Schlünzen L, Simonsen MS, Spangsberg NL, Carlsson P, Cost Consciousness among Anaesthetic Staff.Acta Anaesthesiol Scand 1999;43(2):202-5
• (8). Barbariol F, Deana C, Lucchese F, Cataldi G, Bassi F, Bove T, Vetrugno L, De Monte A, Evaluation of Drug Wastage in the Operating Rooms and Intensive Care Units of a Regional Health Service.Anesth. Analg ;2021(5):1450-1450
• (9). Peker K, The Wastage and Economic Effects of Anaesthetic Drugs and Consumables in the Operating Room.Turk J Anaesthesiol Reanim 2020;48(4):321-7
• (10). Benhamou D, Piriou V, Vaumas CD, Albaladejo P, Malinovsky JM, Doz M, Ready-to-use pre-filled syringes of atropine for anaesthesia care in French hospitals - a budget impact analysis.Anaesth Crit Care Pain Med 2017;36(2):115-21
• (11). Crégut-Corbaton J, Malbranche C, Guignard MH, Fagnoni P, Economic impact of strategies using ephedrine prefilled syringes.Ann Fr Anesth Reanim 2013;32(11):760-5
• (12). Kicker JS, Hill HS, Matheson CK, Better Pairing Propofol Volume With Procedural Needs: A Propofol Waste Reduction Quality Improvement Project.Hosp. Pediatr 2018;8(10):604-10
• (13). Demonaco HJ, Shah AS, Economic Considerations in the Use of Neuromuscular Blocking Drugs.J Clin Anesth 1994;6(5):383-7
• (14). Atcheson CLH, Spivack J, Williams R, Bryson EO, Preventable Drug Waste among Anesthesia Providers: Opportunities for Efficiency.J Clin Anesth 2016;30:24-32
• (15). More SR, Dabhade SS, Ghongane BB, Drug Audit of Intravenous Anaesthetic Agents in Tertiary Care Hospital.J Clin Diagn Res 2015;9(11):25-8
• (16). Alshehri D, Banjar H, Increasing Awareness of Proper Disposal of Unused and Expired Medication Using a Knowledge-Based Disposal Management System.J Environ Public Health 2022;2022:1797440
• (17). Misha K, Nidhi P, Clinical Audit: Awareness of Bio Medical Waste (BMW) Management among OT Personnel.Indian J Clin Anaesth 2020;7(3):405-8

---

More Article by Kamal Singh