Creating Simulated Pharmaceuticals from Laboratory Supplies

1. How to Supply Your Drug Habit Creating Simulated Pharmaceuticals from Laboratory Supplies IMSH2014 - Making Connections

2. Meet Our Team Cory Soto, B.S., CPhT Simulation Specialist Rukhsana Khan, M.P.H. Simulation Specialist Jamie Stiner Simulation Operations Manager Simulation Specialist Daniel Noji, B.S. Programmer Analyst Simulation Specialist Jeffrey Rusheen, M.D. Assistant Professor Anesthesiology

3. Disclosure(s) • We have nothing to disclose. • Commercial vendors mentioned in this presentation are merely used as examples. We do not receive any compensation from them. IMSH2014 - Making Connections

4. Learning Objectives • Create a needs assessment to tailor the pharmaceutical production to your needs. • Demonstrate how to produce vials for use as simulated drugs with hands-on instruction. • Find ways to implement this new tool into your simulation center. IMSH2014 - Making Connections

5. Does your Simulation Center… • Use expired drugs? • Buy commercially available simulated drugs? • Make your own? IMSH2014 - Making Connections

6. The Problems IMSH2014 - Making Connections

7. A Solution: Do It Yourself! IMSH2014 - Making Connections

8. Get The Right Tools for the Job Outside Diameter, or O.D. Syringe Table Salt Borosilicate Vial 0.9% NaCl (Normal Saline) IMSH2014 - Making Connections

9. Get The Right Tools for the Job Stopper Flip-Off Cap Crimper Flip-Off Cap IMSH2014 - Making Connections

10. Step One: Filling and Sealing IMSH2014 - Making Connections

11. Step Two: Capping IMSH2014 - Making Connections

12. Wow, That Was Easy! IMSH2014 - Making Connections

13. Step Three: Crimping IMSH2014 - Making Connections

14. The Assembled Vial IMSH2014 - Making Connections

15. Now You Get To Do It! IMSH2014 - Making Connections

16. Step Four: Labeling IMSH2014 - Making Connections

17. Meet SOPHIE • Simulated Online Pharmaceutical Image Editor • No need for expensive image editing suites • Developed by the UCLA Simulation Center for use by other Simulation Centers at no cost IMSH2014 - Making Connections

18. What Does Your Center Need to Maintain Their Drug Habit? • Common/Crash Cart Meds • Medications for Rare Conditions (Dantrolene for Malignant Hyperthermia, Blood Factors, etc.) IMSH2014 - Making Connections

19. Needs Assessment • Do you see a need for simulated medications to enhance realism and learning during the scenarios? • Are there any injectable drugs you would like specifically created for your simulations? (If so, please include concentration and volume) • Do you have any suggestions for injectable drugs that may be useful for simulation, in general? (If so, please include concentration and volume) • Do you know of any colleagues who would be interested in pharmaceutical simulation or integrating simulated pharmaceuticals into their teaching at the Simulation Center? If so, please provide their name and I will contact them. IMSH2014 - Making Connections

20. Simulated Drugs Currently Available at UCLA IMSH2014 - Making Connections

21. The Cost of Production Material Cost Labor Cost for 500 Vials Labor Cost Per Vial Material Cost Per Vial

22. Cost Per Vial

23. Cost Analysis Total Yearly Cost Using In-House Simulated Drugs versus Commercial Drugs for Anesthesia Residents Assumption: A year’s worth of simulated drugs for Anesthesia residents is based upon 3 vials of simulated drugs used during each simulated case, 3 cases per week, 4 times per month, 12 months per year, which equals a total of 432 vials (with an additional 68 vials as a buffer in case more are needed throughout the year) Total Yearly Cost Using In-House Simulated Drugs versus Commercial Drugs for a Class of 60 Nursing Students Assumption: A nursing program with 60 students learning how to draw medications for intravenous administration. Each get three 10 mL vials of 0.9% NaCl to do this with. Each course occurring 4 times per year. IMSH2014 - Making Connections

24. References • SamoskyJ, Mikulis B, Bregman, R, Nelson, D: A Novel Intravenous Drug Recognition System for Medical Simulators Based on Direct Fluid Identification. Society for Simulation in Healthcare Scientific Abstract Guide 2012; 12: 941 • Steadman RH, Coates WC, Huang YM, Matevosian R, Larmon BR, McCullough L, Ariel D: Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Critical Care Medicine 2006; 34:151-7 • Rodgers D, Securro, Jr S, Pauley RD: The Effect of High-Fidelity Simulation on Educational Outcomes in an Advanced Cardiovascular Life Support Course. Simulation in Healthcare 2009, 4: 200-6 • QayumiK, Donn S, Zheng B, Young L, Dutton J, Adamack M, Bowles R, Cheng A: British Columbia Interprofessional Model for Simulation-Based Education in Health Care. Simulation in Healthcare 2012; 7:295-307 • StruysMMRF, De Smet T, Mortier EP: Simulated Drug Administration: An Emerging Tool for Teaching Clinical Pharmacology During Anesthesiology Training. Clinical Pharmacology & Therapeutics-Nature 2008; 84: 170-4 • Kimble Chase Life Science and Research Products LLC. Web site. • http://labglass.kimble-chase.com/category/serum-vials&bc=100. Accessed March 18, 2013. IMSH2014 - Making Connections

25. How to Reach Us • Any questions or comments regarding the material presented can be directed to the team at: • E-mail: sim@mednet.ucla.edu • Visit our website at: www.sim.ucla.edu IMSH2014 - Making Connections

26. Thank You for Attending Questions? IMSH2014 - Making Connections