Randomized Prospective Study of the Impact of Three Needleless Intravenous Systems on Needlestick Injury Rates

L'Ecuyer, Paul B.; Schwab, Elizabeth Owens; Iademarco, Elizabeth; Barr, Norma; Aton, E.; Fraser, Victoria J.

doi:10.1086/647240

Cited by 20 publications

(21 citation statements)

References 23 publications

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“…The most commonly evaluated safety-engineered devices were needleless intravenous systems (evaluated in 8 of 17 studies) [5,6,11,[14][15][16][17]19], followed by safety syringes [4,5,11,12,19], resheathable winged steel needles [3,5,7,8], vacuumtube blood-collection devices [3,5,7], retractable lancets [4,10], and guarded arteriovenous fistula needles [9]. Eight studies evaluated the introduction of 11 type of device.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Subsets of HCWs were examined primarily when accurate denominators were unavailable for certain occupational groups. For calculation of PI rates, most studies applied measures of person-time at risk, including FTE HCWs [4,5,11,14,16], HCW-days [19], person/worker-years [6,10], and hours/productive hours worked [12,17]. To adjust for differences in device utilization, studies also calculated PI rates using numbers of patient-days [17] and occupied hospital beds [6].…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Safety-Engineered Device Implementation in the Prevention of Percutaneous Injuries: A Review of Published Studies

Tuma

Sepkowitz

2006

Clinical Infectious Diseases

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Nearly 6 years have passed since the Needlestick Safety and Prevention Act of 2000 was signed into law. We reviewed studies published since 1995 that evaluated the effect of safety-engineered device implementation on rates of percutaneous injury (PI) among health care workers. Criteria for inclusion of studies in the review were as follows: the intervention used to reduce PIs was a needleless system or a device with engineered sharps-injury protection, the outcome measurements included a PI rate, the intervention was evaluated in a defined population with clear comparison groups in clinical settings, and outcomes and denominators used for rate calculations were objectively measured using consistent methodology. All 17 studies reported substantial decreases in device-associated or overall PI rates after device implementation (range of reduction, 22%-100%). The majority of studies ( ) were uncontrolled before-after trials with limited ability to control for confounding n p 12 variables. In addition, implementation of safety-engineered devices was often accompanied by other interventions, and direct measurement of outcomes was not performed. Nevertheless, safety-engineered devices are an important component in PI prevention.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Efficacy of Safety-Engineered Device Implementation in the Prevention of Percutaneous Injuries: A Review of Published Studies

Tuma

Sepkowitz

2006

Clinical Infectious Diseases

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“…At least 20 different pathogens have been documented as having been transmitted via sharps injury through body fluid exposure [1,2], with human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) posing the greatest occupational risk to HCWs [3,4].…”

Section: Introductionmentioning

confidence: 99%

Occupational blood and body fluid exposure in an Australian teaching hospital

Tully

Pearce

et al. 2005

Epidemiol. Infect.

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SUMMARYTo examine work-related blood and body fluid exposure (BBFE) among health-care workers (HCWs), to explore potential risk factors and to provide policy suggestions, a 6-year retrospective study of all reported BBFE among HCWs (1998HCWs ( -2003 was conducted in a 430-bed teaching hospital in Australia. Results showed that BBFE reporting was consistent throughout the study period, with medical staff experiencing the highest rate of sharps injury (10 . 4 %). Hollow-bore needles were implicated in 51 . 7 % of all percutaneous injuries. Most incidents occurred during sharps use (40 . 4 %) or after use but before disposal (27 . 1%). Nursing staff experienced 68 . 5% of reported mucocutaneous exposure. Many such exposures occurred in the absence of any protective attire (61 . 1 %). This study indicated that emphasis on work practice, attire, disposal systems and education strategies, as well as the use of safety sharps should be employed to reduce work-related injuries among HCWs in Australia.

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“…Multiple educational interventions and the introduction of several safer devices have contributed to this substantial decrease. [8][9][10][11] Significant differences were found in the patterns of occurrence of percutaneous injury among the hospitals studied. Most published data are from large, adult, urban hospitals, and may not accurately reflect which personnel, locations, equipment, and activities are at the highest risk at other types of facilities.…”

Section: Discussionmentioning

confidence: 95%

Differences in Percutaneous Injury Patterns in A Multi-Hospital System

Babcock

Fraser

2003

Infect. Control Hosp. Epidemiol.

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Objective:Determine differences in patterns of percutaneous injuries (PIs) in different types of hospitals.Design:Case series of injuries occurring from 1997 to 2001.Setting:Large midwestern healthcare system with a consolidated occupational health database from 9 hospitals, including rural and urban, community and teaching (1 pediatric, 1 adult) facilities, ranging from 113 to 1,400 beds.Participants:Healthcare workers injured between 1997 and 2001.Results:Annual injury rates for all hospitals decreased during the study period from 21 to 16.5/100 beds (chi-square for trend = 22.7; P = .0001). Average annual injury rates were higher at larger hospitals (22.5 vs 9.5 Pis/100 beds; P = .0001). Among small hospitals, rural hospitals had higher rates than did urban hospitals (14.87 vs 8.02 PIs/100 beds; P = .0143). At small hospitals, an increased proportion of injuries occurred in the emergency department (13.7% vs 8.6%; P = .0004), operating room (32.3% vs 25.4%; P = .0002), and ICU (12.3% vs 9.4%; P = .0225), compared with large hospitals. Rural hospitals had higher injury rates in the radiology department (7.7% vs 2%; P = .0015) versus urban hospitals. Injuries at the teaching hospitals occurred more commonly on the wards (28.8% vs 24%; P = .0021) and in ICUs (11.4% vs 7.8%; P = .0006) than at community hospitals. Injuries involving butterfly needles were more common at pediatric versus adult hospitals (15.8% vs 6.5%; P = .0001). The prevalence of source patients infected with HIV and hepatitis C was higher at large hospitals.Conclusions:Significant differences exist in injury rates and patterns among different types of hospitals. These data can be used to target intervention strategies.

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Randomized Prospective Study of the Impact of Three Needleless Intravenous Systems on Needlestick Injury Rates

Cited by 20 publications

References 23 publications

Efficacy of Safety-Engineered Device Implementation in the Prevention of Percutaneous Injuries: A Review of Published Studies

Efficacy of Safety-Engineered Device Implementation in the Prevention of Percutaneous Injuries: A Review of Published Studies

Occupational blood and body fluid exposure in an Australian teaching hospital

Differences in Percutaneous Injury Patterns in A Multi-Hospital System

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