The CDC reports that a survey of U.S. healthcare workers who provide medication through injection found that 1% to 3% reused the same needle and/or syringe on multiple patients (some healthcare personnel are unaware of, do not understand, or do not adhere to basic principles of infection control and aseptic technique, which leads to contaminated needles).
The investigation of four large outbreaks of HBV and HCV among patients in ambulatory care facilities in the United States (a private medical practice, a pain clinic, an endoscopy clinic, and a hematology/oncology clinic) led the CDC to define and reinforce safe injection practices.
It was determined that the primary breaches in infection control practice that contributed to the four outbreaks were reinsertion of used needles into a multiple-dose vial or solution container (e.g., saline bag) and use of a single needle/syringe to administer intravenous medication to multiple patients. These outbreaks of viral hepatitis could have been prevented by adherence to basic principles of aseptic technique for the preparation and administration of parenteral medications that include the use of a sterile, single-use, disposable needle and syringe for each injection given and prevention of contamination of injection equipment and medication and, whenever possible, the use of single-dose vials instead of multiple-dose vials, especially when medications will be administered to multiple patients.
The One & Only Campaign (a public health campaign led by the CDC and the Safe Injection Practices Coalition (SIPC) to raise awareness among patients and healthcare providers about safe injection practices) has published the following Safe Injection Practices:
The following recommendations apply to the use of needles, cannulas that replace needles, and, where applicable, intravenous delivery systems:
– Use aseptic technique to avoid contamination of sterile injection equipment.
– 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.
– Use fluid infusion and administration sets (i.e., intravenous bags, tubing, and connectors) for one patient only and dispose appropriately after use. Consider a syringe or needle/cannula contaminated once it has been used to enter or connect to a patient’s intravenous infusion bag or administration set.
– Use single-dose vials for parenteral medications whenever possible.
– Do not administer medications from single-dose vials or ampules to multiple patients or combine leftover contents for later use.
– If multidose vials must be used, both the needle or cannula and syringe used to access the multidose vial must be sterile.
– Do not keep multidose vials in the immediate patient treatment area and store in accordance with the manufacturer’s recommendations; discard if sterility is compromised or questionable.
– Do not use bags or bottles of intravenous solution as a common source of supply for multiple patients.
If you or a family member suffered serious injuries or contracted a serious disease as a result of unsafe injection practices in the U.S., you should promptly seek the legal advice of a local medical malpractice attorney in your state who may agree to investigate your claim for you and represent you in a medical malpractice case, if appropriate.
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