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Transitioning to Ready-to-Administer IV Medications: Can it be Both Safe and Affordable?

Intravenous (IV) therapy is considered an essential component of healthcare delivery, with over 90% of hospitalized patients receiving some form of infusion therapy. Errors involving IV medications can occur in all phases of the medication use process and can be particularly dangerous based on the drug’s properties and the complexity of its therapeutic action.  

Medication errors associated with the administration of the wrong dose and/or wrong concentration are believed to be more prevalent when frontline practitioners are provided with a parenteral product that requires additional manipulation (partial doses, reconstitution, or dilution) at the bedside. In one study of IV medication administration errors, four error types (wrong diluent mixture, wrong diluent volume, wrong “bolus” rate, and drug incompatibility) accounted for over 91% of the errors; 27% of these errors were considered serious. Many organizations, including ISMP and ASHP have stated that to avoid the unnecessary, error-prone complexity of IV push medication preparation and administration, and to avoid the risk of contamination and personnel exposure, all stakeholders should re-evaluate current products administered by IV push and standardize as much as possible to ready-to-administer (RTA) formulations and concentrations. In addition, a cost-effectiveness study comparing ready-to-administer and traditional vial-and-syringe method for opioids showed that manufacturer-prepared prefilled RTA syringe product was found to be cost-effective, demonstrating cost savings by reduction in the error rates. 

Using examples of events that have been reported to the ISMP Medication Error Reporting Program (MERP), faculty will describe the key vulnerabilities when IV medications require manipulation at the bedside that have led to errors and patient harm. The speakers will review data from studies that compare the cost and safety of manufacturer-prepared prefilled ready-to-administer (RTA) products compared to traditional vial-and-syringe products. A director of pharmacy will examine the benefits, challenges and processes associated with the transitioning from traditional vial-and-syringe medications to manufacturer-prepared prefilled ready-to-administer (RTA) products will be examined. 

Begin Activity

Learning Objectives

  1. Describe the risks associated with the preparation and administration of IV medications that are manipulated at the bedside.

  2. Compare studies evaluating the cost and safety comparisons between manufacturer-prepared prefilled ready-to-administer (RTA) products versus traditional vial-and-syringe products.

  3. Describe savings and improved safety from transitioning from traditional vial-and-syringes medications to manufacturer-prepared prefilled ready-to-administer (RTA) products.


John B. Hertig, PharmD, MS, CPPS, FASHP, FFIP, Chair and Associate Professor, Department of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences

Christopher R. Fortier, PharmD, FASHP, Chief Pharmacy Officer, Massachusetts General Hospital, Department of Pharmacy

CE Accreditation

Released: March 10, 2023
Expiration: March 9, 2025

Pharmacists and Pharmacy Technicians
This CE activity is jointly provided by ProCE, LLC and the Institute for Safe Medication Practices (ISMP). ProCE is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. ACPE Universal Activity Number 0221-9999-22-212-H05-P/T has been assigned to this knowledge-based home-study CE activity. This activity is approved for 1.0 contact hour (0.1 CEU) in states that recognize ACPE providers. This CE activity is provided at no cost to participants. Statements of completion will be issued online at upon completion of the evaluation and post-test with a score of 65% or higher. Proof of completion will be posted in NABP CPE Monitor profiles. No partial credit will be given.


This activity is supported by Fresenius Kabi.


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