Hostname: page-component-7c8c6479df-5xszh Total loading time: 0 Render date: 2024-03-28T21:47:19.123Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  02 January 2015

Francisco Alvarado-Ramy
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Elise M. Beltrami
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Louise J. Short
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Pamela U. Srivastava
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Keith Henry
Affiliation:
HIV Program, Regions Hospital, St. Paul, Minnesota
Meryl Mendelson
Affiliation:
Mount Sinai Medical Center, New York, New York
Julie L. Gerberding
Affiliation:
San Francisco General Hospital, San Francisco, California
George L. Delclos
Affiliation:
University of Texas Health Science Center, Houston, Texas
Scott Campbell
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Robin Solomon
Affiliation:
Mount Sinai Medical Center, New York, New York
Rita Fahrner
Affiliation:
San Francisco General Hospital, San Francisco, California
David H. Culver
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
David Bell
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Denise M. Cardo*
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Mary E. Chamberland
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Mailstop E-68, 1600 Clifton Road, Atlanta, GA 30333

Abstract

Objective:

To examine a comprehensive approach for preventing percutaneous injuries associated with phlebotomy procedures.

Design and Setting:

From 1993 through 1995, personnel at 10 university-affiliated hospitals enhanced surveillance and assessed underreporting of percutaneous injuries; selected, implemented, and evaluated the efficacy of phlebotomy devices with safety features (ie, engineered sharps injury prevention devices [ESIPDs]); and assessed healthcare worker satisfaction with ESIPDs. Investigators also evaluated the preventability of a subset of percutaneous injuries and conducted an audit of sharps disposal containers to quantify activation rates for devices with safety features.

Results:

The three selected phlebotomy devices with safety features reduced percutaneous injury rates compared with conventional devices. Activation rates varied according to ease of use, healthcare worker preference for ESIPDs, perceived “patient adverse events,” and device-specific training.

Conclusions:

Device-specific features and healthcare worker training and involvement in the selection of ESIPDs affect the activation rates for ESIPDs and therefore their efficacy. The implementation of ESIPDs is a useful measure in a comprehensive program to reduce percutaneous injuries associated with phlebotomy procedures.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.U.S. Department of Labor, Bureau of Labor Statistics. Table B-1: employees on nonfarm payrolls by industry. In: U.S. Department of Labor, Bureau of Labor Statistics. The Employment Situation: April 2002. Washington, DC: U.S. Department of Labor, 2002. Available at http://stats.bls.gov/news.release/empsittll.htm. Accessed June 29,2002.Google Scholar
2.Panlilio, AL, Cardo, DM, Campbell, S, et al. Estimate of the annual number of percutaneous injuries in U.S. healthcare workers. In: Program and Abstracts of the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections. Atlanta, GA: Centers for Disease Control and Prevention; 2000:60. Abstract S-T2-01.Google Scholar
3.Cardo, DM, Culver, DH, Ciesielski, CA, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med 1997;337:14851490.Google Scholar
4.Centers for Disease Control and Prevention. Documented and possible occupationally acquired AIDS/HIV infection, by occupation. HIV/AIDS Surveillance Report. 2000;12:24.Google Scholar
5.Centers for Disease Control and Prevention. Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures: Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995. MMWR 1997;46:2125.Google Scholar
6.Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens', needlestick and other sharps injuries: final rule. Federal Register 2001;66:53185325.Google Scholar
7.Chiarello, LA, Bartley, J. Prevention of blood exposure in healthcare personnel. Seminars in Infection Control 2001;1:3043.Google Scholar
8.Mendelson, MH, Solomon, R, Bailey, E, Chen, L, McCarthy, D. Efficacy of a “safety” winged steel needle in preventing percutaneous injuries (Pis) in healthcare workers. Presented at the 8th Annual Meeting of the Society for Healthcare Epidemiology of America; 1998; Orlando, FL. Abstract 35.Google Scholar
9.Chiarello, LA. Selection of needlestick prevention devices: a conceptual framework for approaching product evaluation. Am J Infect Control 1995;23:386395.Google Scholar
10.Hamory, BH. Underreporting of needlestick injuries in a university hospital. Am J Infect Control 1983;11:174177.CrossRefGoogle ScholarPubMed
11.Alvarado, F, Panlilio, A, Cardo, D. Percutaneous injury reporting in U.S. hospitals, 1998. In: Program and Abstracts of the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infictions. Atlanta, GA: Centers for Disease Control and Prevention; 2000:118. Abstract P-S2-38.Google Scholar
12.Gershon, R, Pearse, L, Grimes, M, Flanagan, P, Vlahov, D. The impact of multifocused interventions on sharps injury rates at an acute-care hospital. Infect Control Hosp Epidemiol 1999;20:806811.Google Scholar
13.Zafar, A, Butler, C, Podgorny, J, Mennonna, P, Gaydos, L, Sandiford, J. Effect of a comprehensive program to reduce needlestick injuries. Infect Control Hosp Epidemiol 1997;18:712715.Google Scholar