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All vials are not created equal

Premier Communications

Brought to you by the Premier Safety Institute®

Gina Pugliese, RN, MS, editor

October 21, 2013


All vials are not created equal

Single-dose and multi-dose vials can come in any shape and size; you shouldn’t assume a vial is a single or multi-dose vial based on size or volume.
Always check the label! Single-dose vials are for use on only one patient.

In recognition of Infection Prevention Week (October 20-26th), the Premier Safety Institute® is reminding all healthcare providers about the
importance of proper identification and use of medication vials. We are also sharing the new and
dynamic infographic about the use of single and multi-dose vials being released by the One & Only Campaign for educating providers and patients.

*Single-dose or multi-dose?

                     Safety Tips

Before the procedure

  • Carefully read the label of the vial of medication.
  • If it says single-dose and it has already been accessed (e.g. needle-punctured), throw it away.
  • If it says multiple-dose, double-check the expiration date
    and the beyond-use date if it was previously opened, and visually
    inspect to ensure no visible contamination
  • When in doubt, throw it out.
  • Use aseptic technique.

During the procedure


  • Use a new needle and syringe for every injection.
  • Be sure to clean your hands immediately before handling any medication.
  • Disinfect the medication vial by rubbing the diaphragm with alcohol.
  • Draw up all medications in a clean medication preparation area.

After the procedure

  • Discard all used needles and syringes and SDVs after the procedure is over.
  • MDVs should be discarded when:
    • The beyond-use date has been reached
    • doses are drawn in a patient treatment area
    • any time vial sterility is in question

Excerpts from
: One & Only Campaign Infographic: Single-dose vial (SDV) or multi-dose vial (MDV).

Ongoing outbreaks – evidence of harm

Since 2001 at least 50 outbreaks involving unsafe injection practices were reported to CDC, with hundreds of patients being infected. Many of these
outbreaks were related to improper use of both single and multi-dose vials. A single dose vial typically lacks an antimicrobial preservative and can become
contaminated and serve as a source of infection. Multi-dose vials can be used on more than one patient if aseptic technique is followed. However, the CDC
recommends that multi-dose vials be assigned to one patient whenever possible.

CMS enforces policy for single-dose vials for only one patient.

CMS issued a memorandum

maintaining its existing policy that a citation will be issued if single-dose vials are re-entered and used for multiple patients. CDC also issued a
position statement reaffirming its
position that vials labeled by manufacturers as “single-dose” or “single-use” should only be used for one patient to protect against life-threatening

Infographic for provider and patient education

The new dynamic infographic from the One & Only Campaign is
available in two user-friendly formats:

Additional resources:


Safety Institute




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