Impacto en la producción de material contaminante y eficiencia del reetiquetado respecto al reenvasado de medicamentos  <span class="so-article-trans-title" dir="auto"> Translated title: The environmental impact of relabeling process compared with the unitary dose repackaging </span>

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Abstract

Resumen Objetivo: Analizar el impacto en la producción de material contaminante y la eficiencia del reetiquetado con el programa Dale color a tu dosis unitaria respecto al reenvasado. Método: Se analizó la cantidad de material empleado en la elaboración de 100.000 dosis unitarias mediante reetiquetado y reenvasado para calcular el ahorro de material obtenido con el proceso de reeetiquetado. Además, se midió el espacio ocupado por el material contaminante generado en ambos procesos y se realizó una estimación de la producción en función de la capacidad del hospital. Se calculó el coste asociado al material empleado en ambos procesos para el acondicionamiento de 100.000 dosis unitarias, así como el de la maquinaria necesaria para reetiquetar y reenvasar durante 20 años. Resultados: Se generaron 2,11-4,54 kg de plástico en el reetiquetado de 100.000 dosis unitarias (según el formato de etiqueta), y 67,82 kg de material contaminante para la misma cantidad de reenvasados, siendo el reetiquetado 15-32 veces menos contaminante en peso. Además, el reetiquetado supuso un ahorro de 620,64-702,43 m2 de material contaminante (6-13 veces menos contaminante en espacio). Un hospital de tercer nivel que elabore 1-2 millones de reenvasados al año, produciría anualmente hasta 1.356,40 kg de material contaminante. En cuanto a los costes, el reetiquetado supuso un ahorro de material del 89% (1.580 ð), y del 98,2% (17.830 ð) en cuanto a la amortización de la maquinaria durante 20 años. Conclusiones: El reetiquetado parece ser una alternativa más eficiente y respetuosa con el medio ambiente en materia de generación de residuos contaminantes respecto al reenvasado.

Translated abstract

Abstract Objective: To analyze the environmental impact of relabeling process with “Color your unitary dose” program and the efficiency compared to the traditional repackaging. Method: The contaminating material used in the relabeling and repackaging of 100,000 unitary dose was calculated. In addition, the area occupied by the contaminating material produced in both processes was measured to determinate the saving of material with the relabeling process, and an approximate estimation of material production was made according to the hospital capacity. The cost associated to the material required in both processes and the machinery needed to relabeling and repackaging during 20 years was evaluated. Results: The contaminating material used in the relabeling of 100,000 unitary dose was 2.11 kg and 4.54 kg of plastic (depending on the label model used), and 67.82 kg (plastic, aluminum and tracing) in the traditional repackaging process. The area occupied by the contaminating material produced in both processes was 56.81 m2 and 138.60 m2 (relabeling), and 759.24 m2 (repackaging), which means a saving of 620.64 m2 and 702.43 m2 of contaminating material (15-32 times less polluting in weight and 6-13 times, in space). A third level hospital that repackages 2 million unitary dose would annually produce around 1,356.40 kg. A saving of 89% (1,580 ð) of material used was obtained with the relabeling, and 98.2% (17,830 ð) in terms of the cost of amortization of the machinery necessary for 20 years. Conclusions: The relabeling was an efficient and less polluting process than the traditional repackaging system, so we should only use it for medications that can not be relabelled.

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Most cited references 11

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Causes of Medication Administration Errors in Hospitals: a Systematic Review of Quantitative and Qualitative Evidence

Richard N. Keers, Steven D Williams, Jonathan Cooke … (2013)

Background Underlying systems factors have been seen to be crucial contributors to the occurrence of medication errors. By understanding the causes of these errors, the most appropriate interventions can be designed and implemented to minimise their occurrence. Objective This study aimed to systematically review and appraise empirical evidence relating to the causes of medication administration errors (MAEs) in hospital settings. Data Sources Nine electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, Health Management Information Consortium and Social Science Citations Index) were searched between 1985 and May 2013. Study Selection Inclusion and exclusion criteria were applied to identify eligible publications through title analysis followed by abstract and then full text examination. English language publications reporting empirical data on causes of MAEs were included. Reference lists of included articles and relevant review papers were hand searched for additional studies. Studies were excluded if they did not report data on specific MAEs, used accounts from individuals not directly involved in the MAE concerned or were presented as conference abstracts with insufficient detail. Data Appraisal and Synthesis Methods A total of 54 unique studies were included. Causes of MAEs were categorised according to Reason’s model of accident causation. Studies were assessed to determine relevance to the research question and how likely the results were to reflect the potential underlying causes of MAEs based on the method(s) used. Results Slips and lapses were the most commonly reported unsafe acts, followed by knowledge-based mistakes and deliberate violations. Error-provoking conditions influencing administration errors included inadequate written communication (prescriptions, documentation, transcription), problems with medicines supply and storage (pharmacy dispensing errors and ward stock management), high perceived workload, problems with ward-based equipment (access, functionality), patient factors (availability, acuity), staff health status (fatigue, stress) and interruptions/distractions during drug administration. Few studies sought to determine the causes of intravenous MAEs. A number of latent pathway conditions were less well explored, including local working culture and high-level managerial decisions. Causes were often described superficially; this may be related to the use of quantitative surveys and observation methods in many studies, limited use of established error causation frameworks to analyse data and a predominant focus on issues other than the causes of MAEs among studies. Limitations As only English language publications were included, some relevant studies may have been missed. Conclusions Limited evidence from studies included in this systematic review suggests that MAEs are influenced by multiple systems factors, but if and how these arise and interconnect to lead to errors remains to be fully determined. Further research with a theoretical focus is needed to investigate the MAE causation pathway, with an emphasis on ensuring interventions designed to minimise MAEs target recognised underlying causes of errors to maximise their impact.