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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
Once considered shocking outliers, outbreaks of hepatitis and other bloodborne pathogens due to the flagrant reuse of needles, syringes and single-dose vials in ambulatory care settings have almost become the new normal.
Since 2001 more than 150,000 patients have been urged to seek testing for hepatitis C, HBV and HIV following yet another violation of basic injection safety during their care, according to the Centers for Disease Control and Prevention.
Though exposure incidents have occurred in hospitals, the vast majority of outbreaks have been in outpatient clinics, medical offices, long-term care settings and hemodialysis centers. Also, know this: The outbreaks reported to the CDC are almost certainly an undercount. Many infections caused by misused needles and vials are likely missed due to inadequate surveillance systems and lack of public health resources to investigate hepatitis cases with no traditional risk factors (i.e., IV drug injection).
In light of these highly publicized outbreaks, one would certainly think that needle, syringe and vial safety has been heavily emphasized in health care worker training, resulting in a high level of vigilance with correct injection procedures. Or not.
A recent blog by an occupational health nurse suggests a there may still be a “learning gap” about certain aspects of injection safety.
“When teaching about Safe Injection/Safe Needle Practices, I always like to determine the students’ knowledge base regarding these principles,” writes Kim James, MS/FNP-BC, RN, director of Occupational Health Services at Brookdale University Hospital & Medical Center in Brooklyn, NY. “I’m often surprised to find that what I take for granted as a ‘given’ is anything but!”
James’ opening question is, “True or False? Changing the needle between patients makes a syringe safe to reuse.”
A patient’s life could depend on the answer.
“I posed this question at in-services recently conducted at my hospital for resident physicians,” James noted in the blog post. “I hoped all residents would shout ‘That’s wrong!!!’ Very few responded that this statement was False. Imagine my surprise when, at another in-service attended by 23 dental residents, only one hand shot up with the comment, “That is false!”’
Indeed, as several hepatitis outbreaks have shown, merely changing the needle but using the same syringe puts the next patient at risk of infection. The CDC’s One and Only campaign clearly states: “Do not administer medications from a syringe to multiple patients, even if the needle or cannula on the syringe is changed. Needles, cannulae, and syringes are sterile, single-use items; they should not be reused for another patient nor to access a medication or solution that might be used for a subsequent patient.”
Do you think your colleagues would know the correct answer?