目的:ICM有各种尺寸的一次性和多用途小瓶,但CT部门通常只优先储存单个或有限数量的小瓶尺寸。这项研究评估了大型安全网医院的实际ICM废物,并将其与使用各种小瓶尺寸或多用途小瓶的一次性小瓶的估计废物进行比较。
方法:在一个仅储存100毫升ICM小瓶的部门中,对2021年进行的所有CT检查进行了回顾性审查。给予ICM剂量,打开的ICM体积和小瓶数量,和浪费的ICM与使用最佳尺寸的一次性小瓶和多用途小瓶的假设模型进行了比较。还按患者类别比较了对比利用率。
结果:对26,028名患者的49,670次CT的40,393次ICM给药进行了审查,共4,168,335mL造影剂。平均剂量为103mL,模式为100mL。仅使用100mL小瓶会产生1,006,165mL废物(平均废物26mL/给药)。最佳尺寸的一次性使用小瓶产生436,515mL废物(平均废物11mL/给药)。多次使用的小瓶产生537,074mL废物(平均废物13mL/给药)。最佳一次性药瓶大小的分布因患者类别而异(p<0.001),住院检查更适合使用较小的一次性药瓶。
结论:优化ICM库存可以减少50%-59%的造影剂浪费。对造影剂利用率的定期监测可以帮助优化护理环境中的库存选择。我们的回顾性审查支持对ICM库存管理进行审查,以减少浪费,节约成本,并减轻供应链中断的影响。
OBJECTIVE: Iodinated contrast medium (
ICM) is available in single- and multiuse vials of varying sizes, but CT departments often preferentially stock only a single or a limited number of vial sizes. The aims of this study were to assess actual
ICM waste at a large safety-net hospital and to compare with estimated waste if single-use vials in a variety of vial sizes or multiuse vials were used.
METHODS: ICM administrations were retrospectively reviewed for all CT examinations performed in 2021 in a department that stocked only 100-mL
ICM vials. Administered
ICM dose, opened
ICM volume and number of vials, and wasted
ICM were compared with hypothetical models using optimally sized single-use vials and multiuse vials. Contrast use was also compared by patient class.
RESULTS: In total, 40,393 ICM administrations over 49,670 CT examinations among 26,028 patients were reviewed, totaling 4,168,335 mL of contrast media. The mean dose was 103 mL, with mode of 100 mL. Exclusive use of 100-mL vials resulted in 1,006,165 mL waste (mean waste, 26 mL/administration). Optimally sized single-use vials resulted in 436,515 mL waste (mean waste, 11 mL/administration). Multiuse vials resulted in 537,074 mL waste (mean waste, 13 mL/administration). The distribution of optimal single-use vial size differed significantly by patient class (P < .001), with inpatient examinations more amenable to the use of smaller single-use vials.
CONCLUSIONS: Optimizing
ICM inventory can reduce contrast waste by 50% to 59%. Regular monitoring of contrast use may help optimize inventory selection across care settings. This retrospective review supports scrutiny of ICM inventory management to reduce waste, save costs, and mitigate the impacts of supply-chain disruptions.