Nurses and physicians learn early on to use a needle and syringe only once, yet unsafe practices by health care professionals have exposed more than 60,000 patients to hepatitis B or C during the past decade. The Safe Injection Practices Coalition, a group of professional and patient-advocacy organizations, has launched the One & Only Campaign to remind health care workers to use one needle, one syringe, on only one patient.
"In this day and age, it's hard to imagine any health care professional reusing a needle or syringe or improperly using a medication vial and contaminating its contents," said Jackie Rowles, CRNA, MBA, MA, FAAPM, president of the American Association of Nurse Anesthetists (AANA). Yet it keeps happening.
A study released in January by the U.S. Centers for Disease Control and Prevention (CDC) found that more than 60,000 patients were exposed to hepatitis B or C at non-hospital health-care settings, including outpatient clinics, hemodialysis centers and long-term care facilities. Of those patients, 448 developed a hepatitis B or C infection due to the "failure of health care personnel to adhere to fundamental principles of infection control and aseptic technique (for example, reuse of syringes or lancing devices)."
Evelyn McKnight, founder of HONOReform, the Hepatitis Outbreaks National Organization for Reform, was one of those patients. While battling breast cancer, her health care provider reused syringes, spreading hepatitis C to 99 patients at a Nebraska cancer clinic.
"I think it's more of a knowledge gap; that health-care providers are not thinking through all of the steps and all of the ramifications," McKnight said.
Rowles indicated that excuses for reuse can range from saving money to being overworked to ignorance of the standards. Some clinicians say they were ordered to reuse supplies by their bosses.
"I'm sorry, there just isn't a single acceptable reason to reuse—not a single one," Rowles said.
AANA studied the issue in 2003, hiring a market research firm to survey anesthesiologists, other physicians, nurse anesthetists, hospital-based nurses and oral surgeons. The study found that needle/syringe reuse is most prevalent among anesthesiologists (42 percent), somewhat less prevalent among nurse anesthetists (18 percent) and oral surgeons (15 percent), and least common among other nurses (9 percent) and physicians (9 percent).
Same-patient needle/syringe reuse was fairly high, ranging from 9 percent to 56 percent by provider type, while reusing the same needle/syringe on multiple patients ranged from 0 to 3 percent by provider type, including 3 percent of anesthesiologists and 1 percent of CRNAs.
AANA has developed a position statement about safe injection practices and distributed it by mail and email to all of its members and various other nursing groups and health care organizations.
After her personal experience, McKnight formed HONOReform and invited national organizations to join together in a national campaign to educate providers and patients about the dangers of syringe reuse. The Safe Injection Practices Coalition was formed. The coalition's partners include: HONOReform, AANA, CDC, CDC Foundation, Accreditation Association for Ambulatory Health Care, Ambulatory Surgery Foundation, Association for Professionals in Infection Control and Epidemiology, BD (Becton, Dickinson and Company), Nebraska Medical Association, and Nevada State Medical Association.
"I urge nurses everywhere to follow safe injection practices, review universal precaution guidelines, think through each procedure and don't depend on that's how we've always done it," McKnight said. "Be careful and smart about how you are carrying out your injection practices, so they are safe for the patient as well as providers."
Congress has provided $2.5 million to the CDC to fund the One and Only campaign. A pilot educational initiative will roll out in Nevada, where the largest number of exposures—more than 50,000 at an endoscopy center—have occurred.
"As health care providers, we interact with people when they are at their most vulnerable," Rowles pointed out. "Our patients place their trust in us to care for and help heal them; therefore it is our duty to follow the highest standards of care, especially with something as basic as providing a safe, sterile injection."
"There is no reason and no excuse to ever put a patient in jeopardy by reusing a needle or syringe or improperly using a medication vial," she concluded.© 2009. AMN Healthcare, Inc. All Rights Reserved.
One & Only Campaign Promotes Syringe Safety
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