Dating of multidose vials

So you say, I do put the date when I first open/puncture a multi-dose vial. To be in compliance with MM. EP 7, The Joint Commission requires organizations to re-label multi-dose vials with a revised expiration date once the multi-dose vial is opened or punctured.

Just labeling the multi-dose vial with the date opened will not meet the intent of this requirement. Medications in single use vials are preferred over multi-dose vials but avoid the urge to use single use vials for multiple patient use.

The manufacturer's expiration date is based on the fact that the product has not been opened.

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In order to be compliant with this requirement, medications must be labeled with the expiration date so the organization is able to determine when a multi-dose vial is expired.

The Joint Commission defines the expiration date as "the last date that the product is to be used".

For example: Multi-dose Vials To further emphasize the limitations and potential safety hazards of multi-dose vials, The Joint Commission’s FAQs provide insight into how the medication storage requirements outlined under MM., EP 7 will be surveyed.

Identifying Noncompliance The first step to achieving compliance is understanding common areas of noncompliance.

All vials and syringes should be wasted and discarded at the end of the procedure.

To some nurses, this can be an issue especially when there’s still medication left in the vial. Consider the disposal of the remaining medication as a safety step, rather than a waste of resources.Always use a clean needle and syringe with each use of a multi-dose vial. Always check vials for the manufacturer’s expiration date, if before the revised date (sooner than 28 days), then the sooner date is to be used.The only exceptions are vaccines, for which the CDC allows the use of the manufacturer’s expiration date.Also, if sterility is questioned or compromised the multi-dose vials should be discarded regardless of the date.Labeling the multi-dose vial with the date opened will not meet the intent of this requirement.However, many hospitals use insulin pens as “stock” insulin to cover sliding scale insulin protocols.

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