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Poor adherence to aseptic technique in UK hospitals highlighted

Nursing staff in UK hospitals are worse than those in Germany or France at following good aseptic techniques when preparing and administering intravenous drugs, according to data collected in 2001-02 (Quality and Safety in Health Care 2005;14:190).

David Cousins, then at the University of Derby, and colleagues compared systems for preparing and administering intravenous drugs in hospitals in these three countries. Pharmacy staff observed nurses prepare 824 doses and administer 798 doses.
The researchers found that risks existed in the systems studied in all three countries, including those associated with errors in labelling, diluent used, timing and rate of administration and aseptic technique. In the UK, there were 118 (43 per cent) labelling errors and 55 (20 per cent) drugs were administered at least 10 minutes after preparation and were not labelled at all.

During the preparation of 299 doses observed in four hospitals in the UK, the preparation area was never cleaned, hands were never washed nor were sterile gloves worn, and the tops of vials were only swabbed in four cases.

Deviation from aseptic technique was observed in 58 per cent of cases in Germany and 19 per cent of cases in France.

The researchers point out that the National Patient Safety Agency published an alert in September 2004, which required alcohol-based hand rubs to be installed at points of care by April 2005. "This high profile campaign will alert UK health care staff to the importance of hand cleaning and should improve the frequency of hand cleaning before the preparation of intravenous medicines, but this will need to be regularly audited," the researchers advise.

Jonathan Cooke, chief pharmacist at South Manchester University Hospitals NHS Trust, said that it is important to ensure that, wherever possible, intravenous preparations are made in a standardised aseptic dispensary. However, he added that training of nurses is important since there will always be occasions when they have to prepare intravenous drugs on wards. "Aseptic technique training is an important component of medicines management programmes," he said.

Citation: The Pharmaceutical Journal URI: 10019435

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