Frequently Asked Questions




NATIONAL PATIENT SAFETY AGENCY GUIDELINES Q&A


Background

The NPSA guidelines released on 28th March 2007 are aimed at healthcare providers, and provide advice on making sure oral liquid medicines are delivered safely. The aim is to remove any confusion between IV syringes and oral/enteral syringes and avoid incidences of ‘wrong route’ error either from inadvertent injection of oral medication or confusing feeding lines and IV lines.

Who are the guidelines specifically aimed at?

Healthcare providers on neonatal, pediatric or other wards where the possibilities for confusion between IV and oral/enteral administration are most likely.

There have also been recorded incidents of wrong route errors by parents/caregivers at home injecting oral medication, including poorly dissolved crushed tablets. Enteral feeding at home has also increased substantially in recent years.

Which patients does this affect?

Pediatric/neonatal patients who may have oral medication delivered directly into the mouth using a dosing device. They will now have to use an oral/enteral syringe.

All tube fed patients where an IV syringe is currently used must only use an oral/enteral syringe in the future.

As this is just advice, do the healthcare providers have to take notice?

They could choose to ignore it, but as there have been incidents, it would be unwise not to take action.

Do the Baxa ExactaMed™ Oral/Enteral Syringes comply with the guidelines?

Yes, the 17XX range of products have purple plungers and clear labelling to denote oral/enteral use only. All products are validated for single patient reuse, and are packaged sterile. There are three tips available:
  • Oral tip (to fit oral ports). Sizes 1mL – 50/60mL (#1701/1702/1705/1710/1720/1790)
  • Catheter tip (to fit male luer-lock ports). Size 50/60mL(#1750)
  • Female luer-lock tip (to fit catheter ports). Size 50/60mL (#1760)

Are there any exceptions?

Yes, #1770 and #1780 50/60mL Syringes with luer tips do not comply with the guidelines and these will be discontinued. The Baxa nasogastric adaptor, #13005 will also be discontinued as it converts an oral tip to a male luer tip.

How does this affect the Baxa non-sterile ExactaMed Syringes?

Baxa non-sterile, white plunger products with either a clear barrel (#11XX range) or an amber barrel (#16XX range) also fall within these guidelines and will be appropriately labelled before the deadline for compliance by 30th September 2007 if not sooner.

How do Baxa syringes differ from others in the marketplace?

Some other syringes have clear barrels but others are coloured and opaque which can make it difficult for nurses to see the fluid and draw up accurately. The opacity can also obscure particles and air bubbles. These difficulties have been recognised by a number of Trusts already and are not perceived positively.

Baxa Syringes can be washed and reused if required, making them more cost-effective where multiple use of syringes is permitted. They have been tested through 30 washing cycles without significant loss of performance.

None of the Baxa Oral/Enteral Syringes are marked single-use on the barrels or on the outer wrappers meaning they can be reused if Trust policy allows it. However, most competitor syringes are single use and are marked as such. Reuse of a product marked as single use is officially discouraged.

Are oral/enteral syringes more expensive than intravenous syringes?

The NPSA alert makes a clear reference to pricing (see page 6) indicating that oral/enteral syringes currently cost approximately 10 pence more than an equivalent IV syringe. The alert also mentions that they can be washed and reused which is a positive (albeit indirect) endorsement of the reuse of oral/enteral syringes.

When the reuse factor is taken into account, Baxa Oral/Enteral Syringes are actually more cost-effective than single use IV syringes.

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