APIC targets injuries at highest risk

Collaborative efforts needed to implement devices

Trying to strike a balanced position on an emotionally charged issue, the Association for Professionals in Infection Control and Epidemiology (APIC) in Washington, DC, recommends a collaborative approach targeting the injuries at highest risk of transmission in order to accomplish cost-effective implementation of needle-safety devices.

"This information makes it easier to choose which of these safer, but more costly, devices to purchase with limited funds," APIC states in a recently published position paper.1 "To date, many institutions have purchased expensive needleless IV systems to reduce sharps injuries related to IV therapy. Although these systems appear to reduce injuries, such injuries are less likely to transmit bloodborne pathogens than injuries associated with devices used in directly accessing the bloodstream."

Despite data showing fewer injuries in areas where safety devices have been used, cost is frequently cited as a reason for not using them, APIC says. Noting that the replacement of unsafe devices will take a concerted effort by individual institutions, researchers, manufacturers, government agencies, and professional organizations, APIC recommends that the collaborative efforts should encourage:

• timely FDA safety alerts related to the use of conventional needles in high-risk settings to facilitate removal of unsafe devices;

• all institutions to develop active surveillance of device-related sharps injuries and to develop risk-reduction strategies;

• manufacturers to standardize design of sharps devices allowing for universal usage;

• epidemiologic studies to examine the effects of safety devices on risk reduction;

• the transfer of new technology into the workplace through funding for research, consortia study, professional publication of clinical evaluations, and presentations at meetings;

• the formation of coalitions or joint task forces to keep issues in the forefront between and among industries, government, and the health care community;

• the establishment of a central clearinghouse to develop device-specific criteria and to eliminate unsafe products;

• the creation of a nationwide repository for product information, evaluation, and compatibility;

• the development of cost-effective strategies for the implementation of safety technologies.


1. Association for Professionals in Infection Control and Epidemiology. APIC 1997 and 1998 Guidelines Committees. APIC position paper: Prevention of device-mediated bloodborne infections to health care workers. Am J Infect Control 1998; 26:578-580.