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Safety Syringe Designs: How to Select the Most Appropriate Product for Your Healthcare Facility
Medical Devices
In 2000, the Needlestick Prevention Act was passed, which requires healthcare providers to review and update their exposure control plans, to maintain a log of needlestick injuries, and to evaluate and implement the provider's choice of safety syringe and needleless systems. As a result of the Act, all healthcare facilities are now required to perform annual reviews of safety products, including any safety syringe products or newly available technologies.
According to the 2006 Study of Needlestick Injuries and Safety Devices (an independent study sponsored by Inviro Medical
[1]), 70 percent of nurses and 94 percent of directors of infection control surveyed say that they are worried about accidental needlestick injuries among clinicians. Meanwhile, 64 percent of nurses surveyed report being accidentally stuck by a needle, while 82 percent of directors surveyed believe accidental needlestick injuries remain a significant and serious hazard. In addition, a 2007 survey conducted by the American Nurses Association found that 93 percent of nurses believe that integrating a write-on field on a syringe barrel could decrease incidents of medication errors. Clearly, it is in the best interest of all parties involved in the healthcare system, from clinicians to patients, to make sure that the best safety syringe designs are being selected.
Available Safety Syringe Technologies
During the annual review, hospitals should carefully examine the safety syringe products that are currently being used and should also evaluate all of the new options that exist. There are three main safety syringe technologies now available to hospitals to help prevent needlestick injuries:
- Retro-fitted: A conventional syringe with an add-on piece, such as a cap, sheath, or shield that covers the needle.
- Manually retractable: Operating with a simple "Push, Pull, Snap" mechanism to manually withdraw the needle into the syringe barrel and snap off the plunger.
- Automatically retractable: A spring-activated safety syringe that automatically draws the needle back into the syringe barrel after use.
Each of these safety syringe designs has its pros and cons, and it is important for the hospital to consider all aspects of each design. In fact, it is much better to compare and contrast examples of the three technologies rather than to compare different products from one technology. Adopting this approach will ensure a better appreciation of what the market has to offer.
Retro-fitted Syringes
Hospitals may be most familiar with retro-fitted designs, as this was the first type of safety syringe widely introduced for the prevention of needlestick injuries. Retro-fitted designs incorporate a safety mechanism, usually attached to the needle and not to the syringe itself, which can be used to cap the needle. Retro-fitted syringes can impede certain procedures, to the point where a clinician may remove the safety mechanism completely in order to proceed – something that negates the usefulness of the device entirely. In addition, when using the safety mechanism to disable the needle, the clinician's fingers may still come into close proximity with the needle, raising the possibility of needlestick injuries. And since the safety mechanism may be able to be removed after being engaged, it is possible for the syringe to be reused, which can be extremely dangerous.
Automatically Retractable Syringes
Automatically retractable designs may at first be appealing, as the user does not have to do anything upon completion of the injection to avoid needlestick injuries. Working like a ballpoint pen, the needle automatically retracts into the barrel of the syringe. However, such devices may fail if used incorrectly, and there may be aerosolization if retraction is activated outside of the patient. In addition, automatically retractable safety syringe designs are often significantly more expensive than other options.
Manually Retractable Syringes
Manually retractable syringes have the look and feel of conventional syringes. The safety mechanism is integral to the syringe and functions with a simple "Push, Pull, Snap". After pushing to complete the injection, the plunger is pulled back, retracting the needle into the syringe barrel. Snapping the plunger completes the process, permanently disabling the syringe to prevent any possible re-use and reducing the volume for the sharps container. Because the user has control of the mechanism at all times, there is a lowered risk of aerosolization. And the user's hands always remain out of the way of the needle, making it easier to administer injections and reducing the risk of disposal needlestick injuries even further. In addition, manually retractable syringes may be more cost-effective than automatically retractable syringes, which can be important when it comes to a hospital's yearly budget.
Additional Considerations
When researching new or updated safety syringe options to prevent needlestick injuries, a hospital or healthcare facility should also consider the following:
- Easy-to-read gradation markings
- Availability of syringes with low dead space
- Range of syringe sizes
- Low dose options, particularly for syringes to be used for insulin
- Cost
- Syringes that are easily labeled at the time of use, ideally with a write-on field
Summary
During the annual review process, it is important for hospitals and other healthcare facilities to do a complete review of the three different safety syringe technologies that are being used for the prevention of needlestick injuries. By comparing these three technologies, the facility will get a more complete picture of what is available and how each product works. One technology might provide a better solution for individual departments than another; for example, the manually retractable might be preferred in ophthalmology. Consider the pros and cons of each type of safety syringe before reaching a final conclusion on what will work best throughout your facility.
