Best Practice #4 (ARCHIVED) FAQ

Best Practice #4: Ensure that all oral liquids that are not commercially available as unit dose products are dispensed by the pharmacy in an oral syringe.


1. Question: Is the emphasis of this Best Practice on preparing oral doses in oral syringes in the pharmacy, or preparing oral doses in an oral syringe in unit dose amounts versus a bulk bottle?

Answer: The goal of this Best Practice is to avoid having nurses and other healthcare practitioners draw oral solutions into syringes on the patient care unit, where they might use a parenteral syringe. While the emphasis is on providing patient-specific doses in oral or enteral syringes, organizations should consider these additional safety strategies: 

  • Bulk oral solutions should not be stocked in or dispensed to patient care units.

  • If an oral solution is available only in a bulk size, or the patient-specific dose is less than the unit dose amount (e.g., dose is 3 mL when the unit dose oral product is 5 mL), the pharmacy should prepare and dispense the patient-specific dose in an oral or enteral syringe (or cup). Nurses and other healthcare practitioners should not be required to prepare a patient’s dose from a unit dose oral or enteral syringe or cup that holds more than the patient-specific dose.

     

In the event that a nurse or other healthcare practitioner needs to draw an oral solution into a syringe for enteral administration to a patient, ISMP recommends placing oral and/or enteral syringes on patient care units, and educating nurses and other practitioners about their purpose and medication safety value. 

Rev. 3/26/2014

2. Question: For oral syringes, is there is a recommendation to use clear vs. amber syringes? The clear syringes allow the contents to be seen more easily, but the amber ones visually look different than clear parenteral syringes.

Answer: ISMP does not specify whether clear or amber oral (or enteral) syringes should be used.

Rev. 3/26/2014