Safer Practices and Safer Products Reduce Needlestick Injuries
Rita H. Khoury, MD; Asha Gandhi, BS; B. P. Salmon, MS; Joanna Camoia, AS; Melissa Rodriguez, AB; Peter Gudaitis, BA;Dauna Gudaitis, BA
(2013) Abstracts and Case Studies From the College of American Pathologists 2013 Annual Meeting (CAP ‘13). Archives of Pathology & Laboratory Medicine: October 2013, Vol. 137, No. 10, pp. 1343-1526.
Context: It is estimated that 600 000 to 800 000 needlestick/percutaneous injuries occur annually among 8 million health care workers in the United States. Almost half of these are not reported; nurses have the highest percentage of needlestick injuries followed by laboratory workers (phlebotomist), physicians, housekeepers, and other health care workers. Although not all needlestick injuries do involve transmission of blood-borne pathogens, the exposed persons, their coworkers, and family may suffer emotional problems that might last for a long time; the outcome becomes more serious when the injured worker is exposed to HIV.
Design: We reviewed needlestick injuries from 2008–2012 involving phlebotomists drawing blood from residents in long-term care facilities. The needlestick injuries were separated on the basis of cause: drawing blood from uncooperative patients, during safety activation, defective sharp, disposing of sharps, phlebotomist technique, and unknown.
Results: From 2009 to 20122, 576,620 venipunctures were performed and 103 needlestick injuries were reported. Almost half of the cases occurred within the first 6 months of employment; injuries due to technique were more common with new employees. Training/in-servicing phlebotomists on handling difficult patients, and the introduction of Becton Dickinson Vacutainer Push Button Blood Collection, decreased the injuries by 26%.
Conclusions: Most needlestick injuries in long-term care facilities occur when drawing blood from uncooperative patients; training/retraining the phlebotomist on how to handle uncooperative patients is an important key to decreasing the injuries. The laboratory should always search for new and improved safety needles to be used by the phlebotomist. A quality indicator to monitor the needlestick injuries will help to identify a problem and correct it.