ASRA Safety Award Highlights Medication Preparation in Interventional Pain Care

An injection’s preparation deserves attention before the procedure begins. At the 2026 American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) Annual Pain Medicine Meeting, an initiative focused on injectate reproducibility received the organization’s Patient Safety Award, bringing recognition to a practical aspect of interventional pain care.¹

The Baylor College of Medicine project, “Improving Injectate Reproducibility in an Academic Interventional Pain Program: A Quality Improvement Initiative,” was authored by Symonne Martin, MD, and colleagues. The meeting’s public poster listing identifies it as a safety and quality improvement project.^1,2 Its recognition provides an opportunity to revisit established medication preparation guidance and consider how pharmacists can support its implementation.

A Safety Focus Before Administration

Injectate reproducibility concerns the consistency of the solution prepared for administration. The publicly accessible award announcement and poster listing do not describe the Baylor team’s methods or numerical results; conclusions about reductions in errors or improvements in patient outcomes cannot be drawn from those materials.^1,2

The broader practice issue has direct relevance to pain care. ASRA’s infection control guidelines address injectable medication handling, including risks associated with improper storage and failures in aseptic technique. They also distinguish the risks surrounding deeper procedures, where infections can be more serious and harder to recognize early than those following superficial blocks.³

For pharmacists supporting procedural services, that guidance offers a basis for reviewing how medications move from the vial to the patient. An initial review can examine whether written preparation instructions match the workflow staff actually use.

Vial Selection Is a Clinical Decision

ASRA recommends against using single-dose vials for multiple patients. When multidose vials are necessary, the guidelines recommend dedicating them to individual patients whenever possible. Vials used across patients require appropriate storage outside immediate patient care areas and adherence to CDC recommendations.³

A preservative does not eliminate contamination risk. ASRA notes that multidose products remain vulnerable to contamination from improper injection practices. The guidelines recommend disinfecting vial septa with alcohol before access and discarding multidose vials when sterility is compromised or uncertain.³

Pharmacists can use these recommendations when evaluating purchasing choices and storage arrangements with pain teams. Selecting a vial size that fits the procedure also addresses a common source of pressure to retain unused medication: the CDC recommends purchasing the smallest single-dose vial needed and prohibits pooling leftovers for later use.⁴

Preparation Timing and Compounding Matter

The CDC advises preparing injections as close as possible to administration to limit risks to sterility and physical or chemical stability. Where advance preparation is necessary, its guidance identifies manufactured prefilled syringes or products from FDA-registered outsourcing facilities as potential options.⁴

Preparation practices also warrant attention when multiple medications are combined. The CDC states that drawing contents from 2 or more sterile medication vials into 1 syringe falls under United States Pharmacopeia General Chapter <797>.⁴ Pharmacists can help procedural teams identify when a familiar preparation step requires review under sterile compounding standards.

That review should extend to the physical workspace. CDC core practices call for a designated clean medication preparation area separated from contamination sources, including sinks. They also require a new needle and syringe whenever a medication container is entered, even when obtaining additional doses for the same patient.⁵

Making the Workflow Measurable

A practical next step for pain services is to observe preparation alongside the written policy. Pharmacists and procedural staff can identify where instructions are difficult to follow and develop a focused improvement plan.

The CDC recommends monitoring adherence to infection prevention practices, providing regular feedback, and using standardized assessment tools. It also calls for job-specific training before personnel perform their duties, with refresher education at least annually.⁵

The ASRA award recognizes attention to injectate reproducibility; the available public materials do not establish a particular intervention’s effectiveness.^1,2 For pharmacy teams, the actionable opportunity is to apply existing preparation standards consistently and measure whether the workflow supports them.^3-5

REFERENCES

1. New research to be presented at #ASRAFALL26 examines pain treatment, safety, and outcomes. News release. ASRA Pain Medicine. October 29, 2026. Accessed November 13, 2026. ​​https://asra.com/news-publications/asra-update-item/asra-updates/2026/10/29/new-research-examines-pain-treatment--safety--and-outcomes

2. Martin S, Royce C, De Asis O, et al. Improving injectate reproducibility in an academic interventional pain program: a quality improvement initiative. Poster at: 25th Annual Pain Medicine Meeting; November 5-7, 2026; Tampa, FL. Abstract 2468776. Accessed November 13, 2026. https://epostersonline.com/asrafall2026/node/60

3. Provenzano DA, Hanes M, Hunt C, et al. ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine. Reg Anesth Pain Med. Published online July 17, 2025. doi:10.1136/rapm-2024-105651

4. CDC. Preventing unsafe injection practices. March 26, 2024. Accessed November 13, 2026. https://www.cdc.gov/injection-safety/hcp/clinical-safety/index.html

5. CDC. CDC’s core infection prevention and control practices for safe healthcare delivery in all settings. April 12, 2024. Accessed November 13, 2026. https://www.cdc.gov/infection-control/hcp/core-practices/index.html