Amelia Deacon, Associate Medical Science & Commercial Value Liaison, Value & Access, B.Braun Medical Ltd 

Picture a nurse racing between patients on a busy hospital ward. Amid constant interruptions, they attempt to prepare a critical IV antibiotic. Behind them, a phone rings. A colleague needs help. A patient's family member has a question. Meanwhile, multiple precise manipulations await – drawing up solutions, measuring doses, labelling syringes. Each distraction increases error risk {1,2}, yet the medicine must be prepared perfectly. 

This scenario unfolds thousands of times daily across the NHS. The statistics are sobering: 237 million medication errors annually [3], with ~10.1% of IV administrations involving an error [4]. For healthcare professionals, this creates impossible tension between urgency and precision. For patients, it represents potential harm. For the system, it means wasted resources. 

A perfect storm of challenges compounds the problem. A nursing shortage of 42,000 vacancies strains the workforce [5]. Complex medication preparation consumes the equivalent of 4,000 nursing full-time equivalents annually [6]. Environmental contamination with antibiotics endangers staff, with studies detecting eight different antibiotics on preparation surfaces [7,8]. Needlestick injuries have increased by 50% since 2008 [9], with NHS Resolution reporting 1,947 successful claims totalling £10.8 million over the past decade [10]. Meanwhile, with injectable medicines representing £7 billion in annual expenditure [11], studies show alarming wastage – up to 71% of some prepared medications discarded unused [12]

What if we could break this cycle? 

B. Braun's DUPLEX® system offers a compelling alternative. This innovative dual-chamber IV bag keeps drug and diluent separate until activation [13], eliminating complex preparation steps [14]. A study demonstrated that DUPLEX® reduced preparation steps from 18 to 4 and preparation time by 81% compared to traditional methods (4:02 to 0:45 minutes) [14]. The system generated 81% less waste per dose (14.83g vs. 78.04g) and required 90% fewer products [14]

All 102 nurses in the study rated DUPLEX® as "much better" or "better" than traditional methods for preparation safety and ease of use [14]. The system has the potential to significantly reduce errors in real-world settings where distractions are common [15]—precisely where conventional preparation methods are most vulnerable to error. With IV therapy error rates dropping from 73% to just 17% with ready-to-use solutions, the safety implications are substantial [16].

The benefits extend beyond individual patients. By dramatically reducing preparation time [14], DUPLEX® could potentially release thousands of nursing hours back to direct patient care. Environmental contamination risks drop with fewer manipulation steps [14]. Public confidence in the system was high, with 92.3% of study participants (48/52) expressing confidence in home use [14], creating opportunities to improve access to outpatient therapy, potentially freeing up hospital beds. 

While acquisition costs exceed traditional methods, economic analysis demonstrates substantial downstream savings. Research shows shifting 50% of IV medication use to ready-to-use products could yield potential annual savings of €4.9 million in a single hospital [17]. When extrapolated to England's healthcare system, potential annual savings could reach £368.7 million through released nursing time, reduced errors, and decreased waste. 

By transforming medication delivery, ready-to-use medicines offer an opportunity to simultaneously improve patient safety, enhance staff wellbeing, and address system sustainability. The solution is available today – the next step is turning evidence into action.  


References

  1. Prakash V, Koczmara C, Savage P, Trip K, Stewart J, McCurdie T, et al. Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting. BMJ Quality & Safety. 2014 Nov 1;23(11):884–92.
  2. Raja B, Ali S, Sherali S. Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals. Pakistan Journal of Medical Sciences. 2019 Aug 7;35(5).
  3. Elliott RA, Camacho E, Jankovic D, Sculpher MJ, Faria R. Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety. 2021;30(2):96–105.
  4. Sutherland A, Canobbio M, Clarke J, Randall M, Skelland T, Weston E. Incidence and prevalence of intravenous medication errors in the UK: a systematic review. European Journal of Hospital Pharmacy. 2018 Oct 23;27(1):ejhpharm-2018-001624.
  5. The Health Foundation. Nursing locally, thinking globally: UK-registered nurses and their intentions to leave. 2024.
  6. DHSC. Transforming NHS Pharmacy Aseptic Services in England: A national report for the Department of Health and Social Care by Lord Carter of Coles. 2020.
  7. Sessink PJM, Nyulasi T, Haraldsson ELM, Rebic B. Reduction of contamination with antibiotics on surfaces and in environmental air in three European hospitals following implementation of a closed-system drug transfer device. Annals of Work Exposures and Health. 2019 Mar 10;63(4):459–67.
  8. Sessink P, Tans B, Devolder D, Schrijvers R, Spriet I. Evaluation of environmental antibiotic contamination by surface wipe sampling in a large care centre. Journal of Antimicrobial Chemotherapy. 2024 May 9;79(7):1637–44.
  9. Royal College of Nursing. Publications. 2021.
  10. NHS Resolution. Preventing needlestick injuries. 2023.
  11. NHS England. National medicines optimisation opportunities 2023/24.
  12. Barbariol F, Deana C, Lucchese F, Cataldi G, Bassi F, Bove T, et al. Evaluation of drug wastage in the operating rooms and intensive care units of a regional health service. Anesthesia & Analgesia. 2021 Mar 5;132(5).
  13. B Braun US. Ready-to-use DUPLEX Container. 2025.
  14. B Braun. DUPLEX®: An innovative IV antibiotic preparation device to release time to care and aseptic capacity. Poster Abstract Presented at QATS 2024. 2024.
  15. Bragadóttir H, Ingason HT, Gunnarsdóttir S. What happens during nurses’ medication work in acute care: An observational study from one hospital in Iceland. Nordic Journal of Nursing Research. 2014 Dec;34(4):61–3.
  16. McDowell SE, Mt-Isa S, Ashby D, Ferner RE. Republished paper: Where errors occur in the preparation and administration of intravenous medicines: a systematic review and Bayesian analysis. Postgraduate Medical Journal. 2010 Nov 23;86(1022):734–8.
  17. Larmené-Beld KHM, Spronk JT, Luttjeboer J, Taxis K, Postma MJ. A cost minimisation analysis of ready-to-administer prefilled sterilised syringes in a Dutch hospital. Clinical Therapeutics. 2019 Jun;41(6):1139–50.