Premixed Medications During Hospital Labor Shortages

In the wake of the COVID-19 pandemic, hospitals around the globe are experiencing significant labor shortages, particularly in the hospital pharmacy and among nursing staff.1,2 With individual healthcare providers managing higher workloads, hospitals are relying more on products like premixed medications that help save time, increase efficiency and support patient safety.

"Working in the IV (intravenous) room is one of the hardest places to work in the pharmacy, requiring a lot of training and certification to ensure pharmacists and pharmacy technicians can expertly perform all of the necessary functions and understand all of the requirements such as USP sterile compounding standards," said Chuck Ferris, R,Ph., national associate director of pharmacy, Baxter. "This role is typically reserved for seasoned technicians, but worker shortages mean many hospitals no longer have these individuals available. That can put hospitals way behind."

Hospitals can benefit by removing workload from the pharmacy and nurses. One possible solution is using premixed medications whenever possible, allowing pharmacies to focus on compounding those medicines for which no premixed version is available.

Premixed medications are ready-to-use formats of standard doses of commonly prescribed drugs. These products can help simplify and expedite the drug dispensing process as well as help reduce potential errors that may occur when medications are compounded. Compounding, also known as admixing, is the process of combining different ingredients in specific quantities to fill individualized prescriptions.

Leading voices on guidelines for medication safety encourage the use of "commercially prepared, premixed parenteral products" versus products that are manually compounded. They also encourage the use of standard concentrations for safety and efficiency reasons.3, 4

“Premixes work well for several reasons," added Ferris. "Not only do you remove the workload of having to physically compound a medication, but you can actually remove it totally from the IV room. Because premixes are a 'closed system' in an IV bag, you can dispense them from other parts of the pharmacy or even in automated dispensing cabinets (ADCs) close to patient care areas, making them much more accessible to nursing staff."

ADCs provide secure storage for commonly used medications, enabling nurses to quickly access the drug when needed and not having to wait for the pharmacy to prepare the drug and send it to the patient care area. This time savings can be especially important in critical care settings, where every second counts.

"Pharmacists and nurses are busier than ever, but they don’t want to risk potentially delaying a much-needed therapy, or worse, making a medication error," said Ferris. "With premixed, ready-to-use products, staff can 'grab and go' so clinicians can focus on what matters most – their patients."