A Comprehensive Approach to Percutaneous Injury Prevention During Phlebotomy: Results of a Multicenter Study, 1993-1995

Alvarado-Ramy,; Beltrami,; Srivastava,

doi:10.1017/s019594170008509x

Cited by 16 publications

(18 citation statements)

References 5 publications

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“…Support for training as a means of increasing activation rates has been provided by at least one study that found activation rates varying directly with level of training and involvement in the device selection process. (28) This study had several limitations. First, although 149 containers were audited from a cross-section of wards, few or no devices were evaluated from some wards at some hospitals.…”

Section: Discussionmentioning

confidence: 93%

Ongoing Use of Conventional Devices and Safety Device Activation Rates in Hospitals in Ontario, Canada

Stringer¹,

Haines²

2011

Journal of Occupational and Environmental Hygiene

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This study assessed voluntary compliance with the use of sharp safety devices in lieu of conventional ones and the activation status of these safety devices: VanishPoint syringes, Terumo Surshield butterflies, and Insyte Autoguard IV catheters. Sharps disposal containers from various wards in three private, not-for profit, university-affiliated Ontario hospitals were audited during 9 days in August 2007. In the 149 audited sharps containers, 55% of all syringes found were conventional compared with 45% that were safety syringes. In the three hospitals, the percentages of conventional (non-safety) vs. safety syringes found in used sharps containers were as follows, respectively: (i) 72% conventional and 28% safety, (ii) 55% conventional and 45% safety, and (iii) 65% conventional and 35% safety. In addition, it was found that 77% of 2131 Terumo butterflies, 97% of 1117 Insyte Autoguard IV catheters, and 87% of 4897 VanishPoint syringes in the containers had been activated. This study, carried out approximately 1 year before it was legally required to use safety instead of sharp conventional devices, found that most devices in use were conventional ones. It was also found that only the activation rate for the safety IV device was acceptable.

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Section: Discussionmentioning

confidence: 93%

Ongoing Use of Conventional Devices and Safety Device Activation Rates in Hospitals in Ontario, Canada

Stringer¹,

Haines²

2011

Journal of Occupational and Environmental Hygiene

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“…This was primarily due to the lack of well-designed, controlled intervention studies. More recent studies have shown significant reductions in injuries associated with the use of safety devices in cannulation, 122,123 phlebotomy [124][125][126] and injections. 127 It would seem to be logical that where needlefree or other protective devices are used, there should be a resulting reduction in sharps injuries.…”

Section: Sharps Injuries -What's the Problem?mentioning

confidence: 99%

epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Pratt¹,

Pellowe²,

Wilson³

et al. 2007

Journal of Hospital Infection

602

478

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National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were commissioned by the Department of Health (DH) and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were published in January 2001. These guidelines describe the precautions healthcare workers should take in three areas: standard principles for preventing HCAI, which include hospital environmental hygiene, hand hygiene, the use of personal protective equipment, and the safe use and disposal of sharps; preventing infections associated with the use of short-term indwelling urethral catheters; and preventing infections associated with central venous catheters. The evidence for these guidelines was identified by multiple systematic reviews of experimental and non-experimental research and expert opinion as reflected in systematically identified professional, national and international guidelines, which were formally assessed by a validated appraisal process. In 2003, we developed complementary national guidelines for preventing HCAI in primary and community care on behalf of the National Collaborating Centre for Nursing and Supportive Care (National Institute for Healthand Clinical Excellence). A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective in preventing HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. Consequently, the DH commissioned a review of new evidence published following the last systematic reviews. We have now updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the original epic guidelines published in 2001 remain robust, relevant and appropriate but that adjustments need to be made to some guideline recommendations following a synopsis of the evidence underpinning the guidelines. These updated national guidelines (epic2) provide comprehensive recommendations for preventing HCAI in hospitals and other acute care settings based on the best currently available evidence. Because this is not always the best possible evidence, we have included a suggested agenda for further research in each section of the guidelines. National evidence-based guidelines are broad principles of best practice which need to be integrated into local practice guidelines. To monitor implementation, we have suggested key audit criteria for each section of recommendations. Clinically effective infection prevention and control practice is an essential feature of protecting patients. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiri...

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“…The literature review identified articles that referred to rates of effectiveness for the design strategies. Active safety devices, such as the safety scalpel, have widely variable and unpredictable activation rates, in one large series varying between 17% and 90% [1]. The single-handed scalpel blade remover, being a passive device is assumed to be effective 100% of the time it is used; depending of course on the device actually being used, though this can be formalized by incorporating its use into relevant sharps handling policies and procedures.…”

Section: Resultsmentioning

confidence: 99%

“…EPINET (Exposure Prevention Information Network) 2001 data showed that the safety mechanism was fully activated in only 12.1% of cases of sharps injuries reported, was partially activated in a further 16.8% of cases, and that 26.3% of injuries occurred during activation of the safety feature [8]. Alvarado-Ramy et al found activation rates for three "active" safety devices ranged from 17% to 90%, depending on the ease of activation, personal preference of the user, and amount of training [1]. These activation rates relate to single-activation devices only, whereas safety scalpels require activation multiple times, which could result in lower and less consistent rates of activation.…”

Section: Discussionmentioning

confidence: 99%

“Scalpel safety”: Modeling the effectiveness of different safety devices' ability to reduce scalpel blade injuries

Fuentes

Collier

Sinnott

et al. 2008

International Journal of Risk and Safety in Medicine

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Background: The objective of this study was to analyse and compare the potential effectiveness of two safety strategies in reducing scalpel blade injuries. The two strategies examined were safety scalpel vs. a single-handed scalpel blade remover combined with a hands free passing technique (HFPT) (e.g. passing tray or neutral zone).Methods: This was a retrospective study involving review of a 550-bed adult metropolitan tertiary referral hospital's sharps injuries database, chart review, and hypothetical modelling of the data to determine potential preventable injuries. The modelling was done twice, firstly assuming 100% effectiveness of each safety device and secondly using previously published activation rates for "active" safety devices which were considered to be a more accurate reflection of real-life work practices.Results: A total of 141 scalpel injuries were reported between 1987 and 2003. Clinical charts were reviewed for 137 of these injuries. Just under 50% of injuries were sustained while the scalpel was in use and these were assumed to be not preventable. Assuming 100% effectiveness for each safety device resulted in 72 injuries being prevented by safety scalpels and 69 injuries being prevented by a combination of a single-handed scalpel blade remover and an HFPT. When injury prevention was calculated using published data on activation rates for "active" safety devices, the number fell to as low as 12 for safety scalpel and to 61 for the combination of a single-handed scalpel blade remover and an HFPT.Conclusion: Both safety strategies are potentially effective in reducing scalpel blade injuries. However the safety scalpels are active devices and as such are subject to widely variable activation rates. We recommend use of a single-handed scalpel blade remover in combination with an HFPT as this can potentially prevent 5 times as many injuries as safety scalpels.

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A Comprehensive Approach to Percutaneous Injury Prevention During Phlebotomy: Results of a Multicenter Study, 1993-1995

Cited by 16 publications

References 5 publications

Ongoing Use of Conventional Devices and Safety Device Activation Rates in Hospitals in Ontario, Canada

Ongoing Use of Conventional Devices and Safety Device Activation Rates in Hospitals in Ontario, Canada

epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

“Scalpel safety”: Modeling the effectiveness of different safety devices' ability to reduce scalpel blade injuries

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