Heparin administration using prefilled syringes or ampoules: a comparative cost-effectiveness study

Heparin is commonly administered for prophylaxis of thromboembolism in a dose of 5,000iu in 0.2ml subcutaneously twice or three times daily. The presentation may be as a prefilled syringe or as an ampoule. The effect of the presentation on nursing time and the true costs involved has been studied in two London hospitals. Thirty-eight administrations from prefilled syringes and 27 from ampoules were recorded. The mean times to prepare and administer the dose and dispose of the equipment were 67.6 seconds for a prefilled syringe and 128.5 seconds for an ampoule; the mean time saving per dose (95 per cent confidence intervals) was 60.9 (40.8, 80.9) seconds. The total cost per dose using a prefilled syringe was 104p; using an ampoule it was 113p. A generic cost model was created. The use of prefilled syringes saved approximately one minute of time and 9p (8 per cent) in cost per administration.