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Selected Category: Injection Safety

Safe Injection Practices: Establishing the Habit in Residency

Categories: Healthcare-associated infections, Injection Safety

Aaron Rich Ducoffe, MD

Aaron Rich Ducoffe, MD

Guest Author: Aaron R. Ducoffe, MD
US Department of Health and Human Services

In my first few weeks as a Health Policy and Quality Fellow, I immediately became intrigued with the CDC’s One & Only Campaign and its applicability to my former and upcoming planned specialties.

I have learned in residency that a physician’s best and worst habits develop during training. Therefore, even in the midst of a chaotic hospital day, it is crucial that I maintain a mental checklist for every procedure, especially injections.

A frequent encounter concerns the lidocaine vial. Last year, I performed countless lidocaine injections in the ER for suturing wounds and hematoma blocks for fracture reduction. If the vial was multi-use, I always ensured it was stored appropriately – out of the ER bays in a safe, clean area, avoiding the ever-present improperly stored “leftover” vial. Continuing down the checklist, I always utilized sterile needles and syringes as well as proper aseptic technique for both drawing and injecting the lidocaine. These practices[PDF – 1.35 MB] are not only important for subcutaneous injections, but even more so for intra-articular aspirations and injections, vascular access, and at the depths of other interventional procedures often requiring a sterile IR suite, such as spinal injections.

Not Worth the Risk: Failing to Implement Basic Safe Injection Techniques

Categories: Healthcare-associated infections, Injection Safety

Andrew Engel, MD

Andrew Engel, MD

Guest Author: Andrew Engel, MD
International Spine Intervention Society

The International Spine Intervention Society supports the Centers for Disease Control and Prevention’s safe injection practices. As a strong proponent of using evidence-based medicine and safe injection practices, the International Spine Intervention Society agrees with the message espoused by CDC’s new Key Standards for Pain Clinics [PDF – 1.35 MB] poster.  Unfortunately, there continue to be rare (although much too frequent) infections during interventional spine procedures that are directly linked to failures of implementing basic safe injection techniques. Fortunately, the evidence is clear that by simply following safe injection practices physicians can reduce the likelihood of their patients developing infections.

While many providers express concern that they are not adequately reimbursed for providing a new single dose vial for every patient, the emotional and economic consequences in the event of an infection or possibly an outbreak clearly make "One and Only" practice the practical choice. Breaches in sterile technique, including the reuse of single dose vials, can facilitate a single infection turning into an outbreak.

Some will reflect on their years in practice, saying that they have not adhered to one or more of the standards of care and have never seen an infection as a result.  While these physicians should consider themselves lucky, sporadic transmission of blood borne pathogens may not be recognized as having resulted from unsafe injections.  Given the severity of the potential complications, a single preventable infection, let alone an outbreak, is one too many.  It’s not worth the risk.

For more information about patient safety and interventional spine procedures, check out the International Spine Intervention Society’s FactFinder series at https://www.spinalinjection.org/fact-finders.php.

Safe Diabetes Care: Insulin Pens are ONE Person ONLY

Categories: Healthcare-associated infections, Injection Safety

Ann L. Albright, PhD, RD

Ann L. Albright, PhD, RD

Guest Author: Ann L. Albright, PhD, RD
Director, Division of Diabetes Translation,
Centers for Disease Control and Prevention

Diabetes is a chronic condition that is a 24/7 responsibility for everyone who has it. Diligence is necessary to manage diabetes, since its highs and lows can strike while we are otherwise busy with life. It is exciting that there are advances and tools such as the insulin pen to make it easier for people to administer insulin. This is particularly helpful for children, who often must take insulin during the school day, or for those who need to administer insulin while on the go. Diabetes isn’t a convenient disease to live with, no matter what your age.

Along with these tools come great responsibilities, of course, and as health professionals, we can help keep our patients safe. It’s always important to think about how someone uses an insulin pen. The pen can make it easier for people to administer the correct dosage in a timely way, as well as to keep track of only one item, rather than the insulin vial and syringes. But it can also make it easier to share with another individual, without considering the consequences. Teaching people with diabetes to take care of their insulin pen, to use it only for themselves, is essential.

Moving the Needle to Safe Dentistry

Categories: Healthcare-associated infections, Injection Safety

John O’Keefe, BDentSc, MDentSc, MBA

John O’Keefe, BDentSc, MDentSc, MBA

Guest Author – John O’Keefe, BDentSc, MDentSc, MBA
Board Chairman,
Organization for Safety, Asepsis and Prevention (OSAP)

Because safe injection and sharps management practices are central to dentistry, the One & Only Campaign resonates strongly in the dental care sector. That is why the Organization for Safety Asepsis & Prevention (OSAP), the dental sector’s premier organization dedicated to infection prevention and control, is joining the Campaign as a Member. We whole-heartedly support the Campaign and pledge to spread its messages to our members. We are also eager to share information on how we in the dental care sector promote safe injection practices with the healthcare community at large.

It was through my own personal experience in 1984 that I really learned about the importance of safe injection practices and how they relate to creating the safest dental visit possible. I had joined a practice where I was replacing another dentist who had left to set up his own practice elsewhere. I quickly learned that for months this dentist had been taking partially-used local anesthetic carpules from the old practice and re-using them in his new office. I was shocked by this behavior, especially when “one needle, only one time” thinking was already so ingrained in dentistry with regard to local anesthetic practices.

Mind the “Learning Gap!”

Categories: Healthcare-associated infections, Injection Safety

Kim James, MS/FNP-BC RN, Nurse Practitioner, Director of Occupational Health Services, Brookdale University Hospital & Medical Center

Kim James, MS/FNP-BC RN

Guest Author: Kim James, MS, FNP-BC
Director, Occupational Health,
Brookdale University Medical Center

When teaching about Safe Injection/Safe Needle Practices, I always like to determine the students’ knowledge base regarding these principles. I’m often surprised to find that what I take for granted as a “given” is anything but!

This is one reason why, at my “In-Services”, I always ask for a show of hands and ask: “True or False? Changing the needle (between patients) makes a syringe safe to reuse?”  (If you’re familiar with the One & Only Campaign’s “Dangerous Misperceptions” flyer, the answer is “false”.)

I posed this question at in-services recently conducted at my hospital for Resident Physicians.  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!”

Upon asking the Resident why this was a false statement, he said he was not sure.  This triggered a spirited discussion about the importance of changing both the needle as well as the syringe. I suspect some of those Residents questioned it and didn’t speak up, but this is just too important to leave to chance.

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