Environmental awareness leads medical field to question its responsibility and possibilities for action. Drug residues can have a major environmental impact as per their bioaccumulation, toxicity and persistence characteristics, depending on where they are discarded. In France, drug residues should be disposed of by incineration, but in practice, this is not systematic. Moreover, data on drug wastage in Intensive Care Units (ICU) are rare. GAME-OVER observational study aims to evaluate drug wastage in ICU in France and to suggest ways to improve health care practices.
Observational study with data collection during a 24-hour business day. Data collected refer to healthcare team's practices and patients. Collection starts when day shift starts (at 7:00 am) and ends when night shift leaves (at 7:00 am the following day).
Study Type
OBSERVATIONAL
Enrollment
1,066
Drugs are prescribed depending on physician discretion. Specific collection bins are provided to ICU. Healthcare teams discard syringes labelled with name and dilution which have been used to prepare drugs into these bins. After 24 hours of collection, bins are analyzed by investigators.
Centre Hospitalier de Charleville-Mezieres
Charleville-Mézières, Ardennes, France
CHRU de Strasbourg
Strasbourg, Bas-Rhin, France
Hôpital Nord
Marseille, Bouches Du Rhône, France
Centre Hospitalier d'Aurillac
Aurillac, Cantal, France
Groupe Hospitalier Littoral Atlantique
La Rochelle, Charente-Maritime, France
Ratio of overall wastage in milliliter (mL) of prepared and discarded IV drugs to overall volume in milliliter (mL) of prepared IV drugs.
Wastage is defined as any prepared and unused drug that remains in syringe or IV bag.
Time frame: 24 hours
Reason for discarding drug residues
A questionnaire will be fulfilled by healthcare teams with the following possible categories: 1/ prepared in advance and not used ; 2/ systematic change at fixed times ; 3/ prescription change ; 4/ change by anticipation of care ; 5/ drug no longer needed ; 6/ preparation error ; 7/ other reason.
Time frame: 24 hours
Drug residues discarding process
A questionnaire will be used to determine which discarding process are applied by nurses in their usual pratices.
Time frame: 24 hours
Use of enteral administration route
Use of enteral administration route versus per os and IV routes will be analyzed for paracetamol and proton pump inhibitor according to the accessibility of enteral route and the reason and the date of patient entry in ICU.
Time frame: 24 hours
Cost of overall IV drug wastage
Estimated cost of drug residues will be evaluated for each drug, according to the reason for discarding, by the following formula : volume of discarded IV drugs x theoretical price
Time frame: 24 hours
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
CHU de Besançon
Besançon, Doubs, France
Centre Hospitalier de Montélimar
Montélimar, Drôme, France
Hôpital privé Claude Galien
Quincy-sous-Sénart, Essonne, France
HIA Clermont Tonnerre
Brest, Finistère, France
CHRU de Brest
Brest, Finistère, France
...and 51 more locations