TOPIC 6:
MULTI-DOSE VIALS
Presenter: Morgan Messer, ASN, RN
Eric Akosah Appiah, BSN
Division of Infectious Disease and Epidemiology
Tuesday November 16th 12:00pm
AGENDA
• Introductions
• Why Injection Safety Matters for Multi-Dose Vials
• Infection Control Actions for Using Multi-Dose Vials
• Reflection
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LEARNING OBJECTIVES
• Discuss two (2) reasons why injection safety actions are
important when using multi-dose vials.
• Describe at least four (4) injection safety steps to take when
using a multi-dose vial.
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ACKNOWLEDGEMENT
• This Project Firstline Presentation is brought to you by
Division of Infectious Diseases and Epidemiology and
presented by Covid-19 Infection Prevention Consultants
• All presenters have been trained on Project Firstline
materials in correlation with Centers for Disease Control
(CDC).
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INTRODUCTIONS
• Morgan Messer, ASN, RN
• Jamestown, ND
• COVID-19 Nurse
Consultant
• Project First Line
Facilitator
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INTRODUCTIONS
• Eric Akosah Appiah, BSN
• Bismarck, ND
• COVID-19 Nurse Consultant
• Project First Line Facilitator
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NOW LET'S GET TO KNOW YOU!
• What is your professional role?
• What is your healthcare setting that you currently work in?
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What do you
know, right now,
about multi-dose
vials?
8
DEFINITIONS
Multi-dose A multi-dose vial is a vial of liquid medication
vials intended for parenteral administration (injection or
infusion) that contains more than one dose of
medication.
Multi-dose vials are labeled as such by the
manufacturer.
Source: CDC Website. “Questions about
multi-dose vials”. Retrieved from:
https://www.cdc.gov/injectionsafety/pr
oviders/provider_faqs_multivials.html
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What do you
want to know
about multi-
dose vials?
10
WHY INJECTION
SAFETY MATTERS FOR
MULTI-DOSE VIALS
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MULTI-DOSE VIALS ARE DIFFERENT
Multi-dose vials are different.
Multi-dose vials are different from single-dose
vials in several ways and require important
injection safety actions.
Why?
• Multi-dose vaccine vials are accessed by a new needle and syringe
more than once, to pull out individual doses for separate patients.
• Accessing the vial more than once can be an infection control issue.
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INJECTION SAFETY IS SO IMPORTANT!
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CONTAMINATED VACCINES CANNOT BE USED
Contaminated vaccines cannot be used.
• If a needle or syringe gets Why?
dirty and goes into the vial, it • If contaminated vaccine is used
will contaminate the rest of
on a patient, the patient could
the doses of vaccine inside get sick or die.
the vial.
• We don’t want to throw away
• If the vaccine is vaccines that could be given to
contaminated, it cannot be patients.
used anymore and must be
thrown away.
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INJECTION SAFETY ACTIONS ARE
IMPORTANT FOR MULTI-DOSE VIALS
How to implement injection safety actions for multi-dose vials.
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INJECTION SAFETY
Injection safety actions
are important for multi-
dose vials.
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PREPARE THE VIAL
Injection safety actions are important.
Q: Where should multi-dose vials be prepared?
A: Prepare the vial in a quiet, private space. Never
bring multi-dose vials into patient care spaces.
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CHECK THE VIAL
Injection safety actions are important.
Q: What do you want to check before using the vial?
A: Check the label to make sure it is a multi-dose vial,
and it is not expired. Also check to make sure the
vaccine looks the way it is supposed to.
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DISINFECT THE TOP OF THE VIAL
Injection safety actions are important.
Q: Why should you disinfect the top of the vial before
inserting the needle?
A: Disinfect the top of the vial with an alcohol prep
pad to kill any germs on the top, so you don’t push
germs into the vial when you insert the needle. Let
the top dry before you insert the needle.
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ACCESS THE VIAL
Injection safety actions are important.
Q: What do you need to do the first time you open a multi-
dose vaccine vial?
A: How long you can use the vaccine after you first
access the vial varies by product. Writing the date and
time the vial was opened on the label helps prevent
vaccine from being given to a patient beyond its use
date.
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VACCINE IN THE VIAL
Injection safety actions are important.
Q: What do you do if there is a little bit of vaccine left
in the vial, but it’s not enough for a full dose?
A: Throw the remaining vaccine away.
Never combine doses from different vials or
give someone less than a full dose.
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HANDOUT: HOW DO I SAFELY USE A
MULTI-DOSE VIAL?
Multi-Dose Vial
Infection Control
Procedure
Use the checklist to
familiarize yourself with
the appropriate infection
control procedures.
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USING THE CHECKLIST
How Do I Safely Use a Multi-Dose Vaccine Vial?
• Where should you prepare multi-dose vial injections?
• What information should you verify on the vaccine label?
• What information are you responsible for writing on the vaccine label?
Answer the following True or False Questions (if you need help use the How Do I Safely Use a Multi-Dose Vial handout):
• T or F: The vial stopper does not need to be disinfected every time.
• T or F: The top of the vial should be dry before sticking the needle in.
• T or F: Pooling doses from multiple vials is acceptable.
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ONE NEEDLE, ONE SYRINGE, ONLY ONE TIME
The CDC has developed resources to
support the understanding of the
basics of injection safety.
Resources include:
▪ FAQs
▪ Checklists
▪ Patient handouts
▪ Videos on clinical practices
▪ Posters
https://www.cdc.gov/injectionsafety/one-and-only.html
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Reflection
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KEY TAKEAWAYS
• Multi-dose vials require a specific set of safety procedures that are
different from those for single-dose vials or multi-dose vials used
with only one patient.
• Contaminated vaccines cannot be used.
• Injection safety actions are important.
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RESOURCES
Project Firstline on CDC:
https://www.cdc.gov/infection control/projectfirstline/index.html
Project Firstline on Facebook:
https://www.facebook.com/CDCProjectFirstline/
Twitter:
https://twitter.com/CDC_Firstline
Youtube:
https://www.youtube.com/playlist?list=PLvrp9iOILTQZQGtDnSDGViKDdRtIc13VX
CDC’s One and Only Campaign:
https://www.cdc.gov/injectionsafety/one-and-only.html
To sign up for Project Firstline e-mails, click here:
https://tools.cdc.gov/campaignproxyservice/subscriptions.aspx?topic_id=USCDC_2104 References
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REFERENCES
• Acute Hepatitis C Virus Infections Attributed to Unsafe Injection Practices at an Endoscopy Clinic ---
Nevada, 2007. (2008, May 16). Retrieved from
CDC: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5719a2.htm
• Folkema, A., Wang, H. L., Wright, K., Hirji, M. M., Andonov, A., Bromley, K., Ludwig, C., & MacArthur, A.
(2021). An outbreak of hepatitis C virus attributed to the use of multi-dose vials at a colonoscopy clinic,
Waterloo Region, Ontario. Canada communicable disease report = Releve des maladies transmissibles
au Canada, 47(4), 224–231. https://doi.org/10.14745/ccdr.v47i04a07
• Injection safety CDC: References | Injection Safety | CDC
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EVALUATION
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for CEU certificate:
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attendee will need to complete the
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Submit all forms
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[email protected] for certificates.
Recordings can be found on:
www.health.nd.gov/projectfirstline
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QUESTIONS?
Call us: (701)-328-2378
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