Multicenter Study on Environments for the Preparation of Infusions in Clinical Wards and Related Prescriptions

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  • KATSUDA Yu
    Department of Pharmacy, Shimizu Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • KOSAKA Tadashi
    Department of Pharmacy, University Hospital, Kyoto Prefectural University of Medicine KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • MURATA Tatsunori
    Department of Pharmacy, Kyoto City Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • FUNAKOSHI Mari
    Department of Pharmacy, Japanese Red Cross Society Kyoto Daiichi Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • INOUE Takayuki
    Department of Pharmacy, JCHO Kyoto Kuramaguchi Medical Center KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • YAMASHITA Michiko
    Department of Pharmacy, Shin Kyoto Minami Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • SUGITA Naoya
    Department of Pharmacy, Ayabe City Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • KATSUI Yasushi
    Department of Pharmacy, Fukuchiyama City Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • SAWADA Shinji
    Department of Pharmacy, Japanese Red Cross Society Kyoto Daini Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • OHONO Seiko
    Department Infection Control, Japanese Red Cross Society Kyoto Daiichi Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • SHIMIZU Tsunehiro
    Division of Infectious Diseases, Kyoto City Hospital KIPS–P; Kyoto Infection Prevention Society for Pharmacist
  • FUJITA Naohisa
    Division of Infectious Diseases, University Hospital, Kyoto Prefectural University of Medicine KIPS–P; Kyoto Infection Prevention Society for Pharmacist

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Other Title
  • 病棟における輸液調製環境と輸液処方に関する多施設間実態調査
  • ビョウトウ ニ オケル ユエキ チョウセイ カンキョウ ト ユエキ ショホウ ニ カンスル タシセツ カン ジッタイ チョウサ

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Abstract

  Preparation of infusions on clinical wards requires preventive measures against contamination. To clarify the current status of infusion preparation, a multicenter study was conducted, involving hematology and surgery wards and focusing on air cleanliness, environments for preparation, and the content of each infusion. The air cleanliness level was measured in 9 departments of 5 facilities, using a particle counter and air sampler to identify airborne particles and microbes and clarify the number of colonies per 1 m3. Environments for the preparation of infusions and infusion contents were examined in 13 departments of 9 facilities by confirming the sites of preparation and totaling the numbers of injection prescription sheets issued during a 10–day period (a total of 7,201 prescriptions). Measurement of air cleanliness found the number of particles with a diameter of 5 μm or larger in a department ranged from 3,091×103 to 393×103/m3. Airborne microbes analysis found Staphylococcus aureus in only 3 departments, but detected human- or environment-derived CNS (coagulase negative staphylococci) and Micrococcus, Corynebacterium, and Bacillus species in all departments. Preparation tables were placed directly underneath air conditioner outlets in 9 departments (69%), and interfered with staff traffic lines in 10 departments (77%). Approximately 31% of the 4,089 prescription drugs, which had been subject to accidental mixture, were used for 3–hour or longer infusion. Manuals for the preparation of infusions on wards were available in only 3 of the 9 facilities. Considering the low air cleanliness level in areas with preparation tables, and the finding that more than 30% of prescription drugs were used for 3–hour or longer infusion, the risk of bacterial contamination is likely to be high. Guidelines for the appropriate preparation of infusions on clinical wards should be established to reduce such risks.<br>

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