Protecting the Hospital Cold Chain and Saving Money at The Princess Royal University Hospital

The Challenge

The Aseptic unit within a Pharmacy department dispenses ready-made Total Parenteral Nutrition bags (TPN). If unused these bags are disposed of because they contain additives that are temperature sensitive. There is usually no way of being able to validate whether or not the cold chain that these products need to be kept in has been breached once the product reaches a ward or department after it has left the Pharmacy.

TimestripPlus threshold indicators record the cumulative time that a temperature sensitive product has spent above its maximum storage temperature threshold. They do not require any pre-conditioningecopy prior to activating them, which is achieved by simply squeezing a blister. They can be applied directly to the product and once they are active, Timestrip Plus threshold indicators display cumulative temperature breaches through a coloured liquid, which moves across the window each time the threshold is breached. This progression then stops once the product is returned to the correct storage temperature.

The Solution

The Aseptic Services Unit at Princess Royal University Hospital have been using TimestripPlus threshold indicators in connection with the transport and storage of ready-made TPN bags (Total Parenteral Nutrition) since August 2009. Each ready-made TPN bag has had a TimestripPlus TP078 indicator attached to it before it is dispensed. Whenever the bag is taken from its cold box or ward fridge and placed at ambient temperatures the Timestrip Plus indicator starts to record the amount of time, and only stops once the product is returned to below 8oC. Bags that are returned to the Pharmacy can be re-used at a later date if they are shown (by the Timestrip Plus) to have been stored correctly. With the assurance provided by Timestrip Plus threshold indicators, the Aseptic Unit has managed to re-use 75% of the ready-made TPN bags that were returned unused over the past year. This has generated a significant cost saving that in past years would have been impossible to achieve because there was no way to measure the temperature breaches.  

Kate Russell, Senior Technician for Aseptic Services at Princess Royal University Hospital commented: "Although we have to pay for the outlay of the Timestrip Plus indicators this is definitely less than the cost saving that we are making and means our wastage is greatly reduced.” 

Standard Operating Procedure

The use of TimestripPlus has been written up as a Standard Operating Procedure at Princess Royal for the use with TPN products. TimestripPlus indicators can provide this level of assurance for all products that have the potential to break the cold chain in which they are placed.