Wednesday, December 14, 2011

Safer Needle Devices

Safer Needle Devices

Most needlestick injuries result from unsafe needle devices rather than carelessness by healthcare workers (JSHQ, 1998, Summer).

Safer needle devices have built-in safety control devices, such as those that use a self-sheathing needle, to help prevent injuries before, during, and after use through safer design features.

The Centers for Disease Control and Prevention (CDC) estimated in March of 2000 that 62 to 88 percent of sharps injuries in the hospital setting could be preventing by using safer medical devices.

Potential Hazard

According to the Bloodborne Pathogens Standard, employers with the help of employees, must select safer needle devices to use in work environments.
  • There are different types of safety features that are available for safer needle devices such as:
    • Needleless devices

    • Passive safety features: remain in effect before, during and after use.
      • Integrated safety design: have a safety feature that is built in as an integral part of the device and cannot be removed. This design feature is usually preferred.
    • Active devices: require the worker to activate the safety mechanism.

      • Accessory safety devices: have safety features that are external to the device and must be carried to, or be temporarily or permanently fixed to, the point of use. This design is dependent on employee compliance and according to some researchers, is less desirable.
  • Desirable Characteristics of Safety Devices include:

    • The device is needleless.

    • The safety feature is an integral part of the device.

    • The device is easy to use and practical.

    • The device performs reliably.

    • The safety feature cannot be deactivated and remains protective through disposal.

    • The devices work effectively and reliably, and are acceptable to the healthcare worker, and do not adversely affect patient care.

    • The Food and Drug Administration (FDA) is responsible for clearing medical devices for marketing in the US. It recommends safer needle devices with a fixed safety feature that:

      • Provides a barrier between the hands and the needle after use; the safety feature should allow or require the worker's hands to remain behind the needle at all times.

      • Is an integral part of the device and not an accessory.

      • Is in effect before disassembly and remains in effect after disposal to protect users and trash handlers, and for environmental safety.

      • Is as simple as possible, and requires little or no training to use effectively.
There are many types of safety devices. Some examples of safety device designs include:
  • Needleless Connector Systems: Needleless connectors for IV delivery systems (e.g., blunt cannula for use with prepierced ports and valved connectors that accept tapered or luer ends of IV tubing) (Figure 1).

  • Self-Sheathing Safety Feature: Sliding needle shields attached to disposable syringes and vacuum tube holders (Figures 2A and 2B).

    • Disposable scalpels with safety features such as a sliding blade shield (Figure 6).

  • Retractable Technology: Needles or sharps that retract into a syringe, vacuum tube holder, or back into the device.

    • Syringe with a retractable needle (Figure 3).

    • Retractable finger/heel-stick lancets (Figure 8).

  • Self Blunting Technology: Self-blunting phlebotomy and winged-steel "butterfly" needles (a blunt cannula seated inside the phlebotomy needle is advanced beyond the needle tip before the needle is withdrawn from the vein (Figure 4), (Figure 5).

  • Hinged Safety Feature: Hinged or sliding shields attached to phlebotomy needles, winged steel needles, and blood gas needles (Figure 7). 

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