FORT LAUDERDALE, Florida — Using a retractable steel needle instead of a resheathable needle decreased the rate of accidental needle-stick injuries by almost half among nurses and phlebotomists at a large hospital in New York City.

Alexandra Derevnuk

"We were getting approximately 50 needle sticks a year in our institution because of the cumbersome nature of the device we were using to draw blood," Alexandra Derevnuk, RN, coordinator of infection control and blood and body fluid exposure at the Mount Sinai Medical Center in New York City, told Medscape Medical News.

"When we switched, this went down to 25 needle sticks per year. We are happy with this result, but our ultimate goal is to get that number down even lower, ideally to zero," Derevnuk said here at the Association for Professionals in Infection Control and Epidemiology (APIC) 2013 Annual Meeting.

From 1999 to 2010, the 1100-bed urban center used a resheathable safety winged steel needle device for phlebotomy. This device required staff to activate the safety feature by sliding the sheath over the sharp end of the hollow bore needle, which caused many percutaneous injuries.

Despite routine and aggressive educational campaigns, there was no substantial reduction in the rate of needle sticks, Derevnuk said.

 
We were getting approximately 50 needle sticks a year in our institution because of the cumbersome nature of the device we were using.
 

In 2010, Mount Sinai switched to a retractable winged steel needle. "The feedback from the nurses and the phlebotomists was very positive. They love this product, compared with the other one, which was very clumsy to use," she said. "By the time the phlebotomist takes the needle from the patient's arm, there is no sharp device to be stuck with, thanks to the pushbutton feature."

The new device is more expensive than the one it replaces but the extra cost is worth it, Derevnuk added.

She and her team retrospectively reviewed the impact of switching to the new device for phlebotomy.

They looked at the number of percutaneous injuries recorded from 2007 to 2010, when the resheathable needle was in use, and compared that with the number that occurred in 2011 and 2012, after the implementation of the pushbutton needle.

Their review showed that the new device was associated with a significant reduction in percutaneous injuries.

Table. Winged Steel Needle Injuries Before and After the Switch

Outcome Resheathable (2007 to 2010) Pushbutton (2011 and 2012)
Total needle injuries 195 50
Average needle injuries per year 49 25
Rate of needle-stick injuries per 100 beds* 5.5 2.85
*P = .01

 

Marcia Patrick

"Retractable technology is better and more effective than technology where you have to do an action to activate the device," said Marcia Patrick, RN, an infection preventionist from Tacoma, Washington, who was asked by Medscape Medical News to comment on the study.

"With the resheathable winged needle, you inserted it, drew blood or connected it to the IV, or whatever you needed to do, and then you had to stabilize it with one hand and slide the cover until it clicked over the needle, all while the needle is still inside the patient. Then, after you pulled it out, you had to hold it while you put gauze on the patient so they didn't bleed, which was cumbersome," said Patrick, who is on the practice guidance committee of the APIC.

"The results of this review show that the retractable winged needle is a very important piece of safety technology. It's not a silver bullet — there are multiple things that are involved in needle sticks," she said, "but it is an important advance in reducing their number."

Ms. Derevnuk and Ms. Patrick have disclosed no relevant financial relationships.

Association for Professionals in Infection Control and Epidemiology (APIC) 2013 Annual Meeting: Abstract 8-350. Presented June 9, 2013.

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