Drug Wastage : Observational Study in the Operating Rooms of France

Study Overview
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Brief Summary
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Environmental awareness is leading medical field to question its responsibility and possibilities for action. Drug residues can have a major environmental impact as per their bioaccumulation, toxicity and persistence characteristics, depending on where they are discarded. In France, drug residues should be disposed of by incineration, but in practice this is not systematic. Moreover, data on drug wastage in the operating rooms by anesthesia department are rare. The GAME-OvBLOC observational study aim to evaluate drug wastage in the operating rooms by anesthesia department in France and to propose ways of improving health care practices.

Detailed Description
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Observational study with data collection over a 24-hour business day. Data collected refer to healthcare team's practices and patients.

Official Title
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Drug Wastage : Observational Study in the Operating Rooms of France

Conditions
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Drug Use

Intervention / Treatment
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* Other: Quantification of injectable drugs wastage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients who will need an anesthesia act in operating room during a 24 hours period Exclusion Criteria: Patient opposition to participate in the study or parents opposition if the patient is a child or patient family opposition if the patient is not capable of being informed
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Injectable drugs<br>Patient's data and data relating to prepared/administrated/discarded injectable drugs will be collected during 24 hours in the operating rooms by anesthesia department | Other: Quantification of injectable drugs wastage<br>* Drugs are prescribed at discretion of physicians. For each patient who have anesthesia in the operating room, all labelled syringes having contained drugs (name + dilution) are collected and analyzed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ratio of overall wastage in milliliter (mL) of prepared and discarded injectable drugs, to overall volume in milliliter (mL) of prepared injectable drugs | Wastage is defined as : any prepared and unused drug that remains in syringe | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reason for discarding drug residues | The reason of waste full syringe will be noticed : 1/ prepared in advance and not used ; 2/ prescription change ; 3/ preparation error ; 4/ other reason | 24 hours | 
| Describe drug wastage for each kind of surgery/anesthesia | Drug wastage according to type of surgery and anaesthesia | 24 hours | 
| Drug residues discarding process | Questionnaire on nursing practices on the choice of waste disposal circuits according to drugs | 24 hours | 
| Cost of overall injectable drugs wastage | Estimated cost of drug residues will be evaluated for each drug by the following formula : volume of discarded injectable drugs x theoretical price | 24 hours | 
| Describe drug wastage for each age group | Drug wastage according to the following age groups : adult (≥18 years old) and pediatrics (< 1 year old, 1-5 years old, ≥ 6 years old) | 24 hours | 
| Describe waste and environmental impact of used plastic syringes | Number and volume of used syringes, use of pre-filled syringes, refilling of syringes and multi-patient use. Environmental impact is indirectly assessed by type of plastic used and the transport distance from the production site to France. | 24 hours | 
| Use of alternative to injectable drugs | Alternatives : local anaesthesia and anaesthetic gases | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Drug wastage, Green Anesthesia, Environmental sustainability, Injectable drugs, Eco-design of care, Operating Room