Needlestick injuries in a major teaching hospital: The worthwhile effect of hospital-wide replacement of conventional hollow-bore needles
Hospital-wide adoption of SEDs, particularly retractable syringes, resulted in a significant and sustained decline in NSIs, improving worker safety across multiple departments.
Key Findings
- Baseline problem: Hollow-bore NSI rates remained constant for 10 years pre-intervention (3.01–3.77 per 100 FTE).
- Intervention: Safety-engineered devices (SEDs) including VanishPoint retractable syringes were introduced following a hospital-wide education program.
- Substantial reduction: Post-intervention rates dropped to 1.93 per 100 FTE in 2005 and 1.50 in 2006, representing a 49% decrease compared with the 5-year pre-intervention average.
- High-risk injuries: Hollow-bore injuries fell 57% (from 72 in 2004 to 31 in 2006). IV line-related injuries were virtually eliminated (81% reduction).
- Other device injuries: Winged butterfly needle injuries decreased 35%. No significant change was observed in suture needle or cannula/stylet injuries.
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Practical obstacles:
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Confusion occurred between 1 mL tuberculin and insulin syringes.
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Insulin pen–related NSIs emerged but were resolved by switching to retractable syringes.
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Prefilled nonsafety syringes (e.g., enoxaparin) caused six NSIs.
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Conclusion: Hospital-wide adoption of SEDs, particularly retractable syringes, resulted in a significant and sustained decline in NSIs, improving worker safety across multiple departments.
Abstract/Summary
This study evaluated the effect of introducing safety-engineered devices (SEDs) — including retractable syringes, needle-free intravenous systems, and safety butterfly needles — at an 800-bed Australian teaching hospital. Prospective monitoring compared preintervention needlestick injury (NSI) data (2000–2004) with two years post-intervention (2005–2006). Results showed a 49% reduction in hollow-bore NSIs, primarily from the elimination of IV line-related injuries (81% decline). High-risk hollow-bore injuries fell 57%. Winged butterfly needle injuries dropped by 35%. Suture and cannula-related NSIs did not significantly change. Practical challenges included syringe confusion, insulin pen-related injuries, and limitations in syringe applicability (e.g., 10 mL volumes, partial injections, prefilled nonsafety syringes). Overall, SEDs significantly reduced high-risk injuries and improved healthcare worker safety.
Publication/Source
American Journal of Infection Control (AJIC), April 2008
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