Phlebotomy Devices Research Articles

Assessing Phlebotomy Device Preference and Specimen Quality in an Oncology Outpatient Clinic.

Oncology patients have frequent venipunctures, which causes scarring, making subsequent draws difficult and painful. Novel blood collection systems may decrease discomfort in patients experiencing repeat blood draws. Oncology outpatients (n = 101; criteria excluded 12) were recruited to determine their preference for either of two blood collection systems, the 23-gauge standard BD Vacutainer Push Button Blood Collection Set (Standard Push Button system) or the 25-gauge BD Vacutainer UltraTouch Push Button Blood Collection Set (UltraTouch Push Button system). Subjects received two blinded, randomized blood draws, one with each device and just one device for each arm. Subjects subsequently rated their blinded preference for blood collection system. Specimen quality was assessed for each device with measurements for plasma hemoglobin (Shimadzu UV-1800 spectrophotometer, Shimadzu), lactate dehydrogenase, and potassium (Vitros 4600/5600 analyzer, Ortho Diagnostics). Preference for the 25-gauge UltraTouch Push Button system over the 23-gauge Standard Push Button system was significant (UltraTouch, n = 51; Standard n = 30; no preference, n = 8; P = 0.0196). Regarding sample quality, the 25-gauge UltraTouch Push Button system had significantly lower plasma hemoglobin (average 5.34 mg/dL) vs the 23-gauge Standard Push Button system (9.37 mg/dL; P < 0.0001); serum lactate dehydrogenase and potassium differences were not statistically significant. Subjects in an oncology clinic preferred phlebotomy with the 25-gauge UltraTouch Push Button system, and samples using this device had less hemolysis as assessed by plasma hemoglobin.

Assessment of safe injection practices in health facilities in Oman.

Unsafe injection practices put patients and providers at risk of infectious and noninfectious adverse events. A 2001 Ministry of Health survey on injection practices in Oman indicated that, while overall standards were good, in some areas there was a need for improvement. We aimed to evaluate injection safety practices to determine whether facilities meet the requirements for practices, equipment, supplies and waste disposal, and to identify unsafe practices. We conducted a national cross-sectional survey in 2007 using the World Health Organization tool to evaluate injection safety practices. Using 2-stage cluster sampling, 80 government and 61 private health facilities were randomly selected and evaluated. There was no shortage of injection equipment nor evidence of attempts to sterilize disposable devices. Care providers immediately disposed of the used needle/syringe in sharps containers. Phlebotomy devices were taken from sealed packets in 96% of facilities. In private facilities, 66.3% of the care providers were fully immunized against hepatitis B. Wearing a new pair of gloves for phlebotomy was observed in only 46% of government and 38% of private health facilities. Many health facilities lacked alcohol-based handrub. Many injection safety aspects were satisfactory. However there are still opportunities for improvement. Actions are required to make alcohol-based handrub and appropriate sharps containers available and to provide hepatitis B vaccine and training to health care workers in all facilities.

Novel Opportunities for Improving the Quality of Preanalytical Phase. A Glimpse to the Future?

Summary The preanalytical phase is crucial for assuring the quality of in vitro diagnostics. The leading aspects which contribute to enhance the vulnerability of this part of the total testing process include the lack of standardization of different practices for collecting, managing, transporting and processing biological specimens, the insufficient compliance with available guidelines and the still considerable number of preventable human errors. As in heavy industry, road traffic and aeronautics, technological advancement holds great promise for decreasing the risk of medical and diagnostic errors, thus including those occurring in the extra-analytical phases of the total testing process. The aim of this article is to discuss some potentially useful technological advances, which are not yet routine practice, but may be especially suited for improving the quality of the preanalytical phase in the future. These are mainly represented by introduction of needlewielding robotic phlebotomy devices, active blood tubes, drones for biological samples transportation, innovative approaches for detecting spurious hemolysis and preanalytical errors recording software products.

Use of safety-engineered devices by healthcare workers for intravenous and/or phlebotomy procedures in healthcare settings: a systematic review and meta-analysis.

BackgroundThe acquisition of needle-stick injuries (NSI) in a healthcare setting poses an occupational hazard of transmitting blood-borne pathogens from patients to healthcare workers (HCWs). The objective of this study was to systematically review the evidence about the efficacy and safety of using safety-engineered intravenous devices and safety-engineered phlebotomy devices by HCWs.MethodsWe included randomized and non-randomized studies comparing safety-engineered devices to conventional/standard devices that lack safety features for delivering intravenous injections and/or for blood-withdrawal procedures (phlebotomy). The outcomes of interest included NSI rates, and blood-borne infections rates among HCWs and patients. We conducted an extensive literature search strategy using the OVID interface in October 2013. We followed the standard methods for study selection and data abstraction. When possible, we conducted meta-analyses using a random-effects model. We used the GRADE methodology to assess the quality of evidence by outcome.ResultsWe identified twenty-two eligible studies: Twelve assessed safety-engineered devices for intravenous procedures, five for phlebotomy procedures, and five for both. Twenty-one of those studies were observational while one was a randomized trial. All studies assessed the reduction in NSIs among HCWs. For safety-engineered intravenous devices, the pooled relative risk for NSI per HCW was 0.28 [0.13, 0.59] (moderate quality evidence). The pooled relative risk for NSI per device used or procedure performed was 0.34 [0.08,1.49] (low quality evidence). For safety-engineered phlebotomy devices, the pooled relative risk for NSI per HCW was 0.57 [0.38, 0.84] (moderate quality evidence). The pooled relative risk for NSI per device used or procedure performed was 0.53 [0.43,0.65] (moderate quality evidence). We identified no studies assessing the outcome of blood-borne infections among healthcare workers or patients.ConclusionThere is moderate-quality evidence that the use of safety-engineered devices in intravenous injections and infusions, and phlebotomy (blood-drawing) procedures reduces NSI rates of HCWs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1705-y) contains supplementary material, which is available to authorized users.

Subjective Evaluation of Winged Steel Phlebotomy Devices by Healthcare Workers

either at our facility or from another facility/provider. It is likely that the 15% increase was directly attributed to the perceived inconveniencewearing themask. Due to the rapid and early peak of the influenza in South Carolina, we did not send letters to those who declined vaccination. Instead regular updates were sent to staff from Employee Health and the Chief Medical Officer with current local and regional surveillance data. Many unvaccinated employees rescinded their declinations and received the vaccine. Nearing the season’s end, our vaccination rate had increased to 83.7%, a 32% increase over last year’s rate.

Contribution of a Winged Phlebotomy Device Design to Blood Splatter

Despite a proliferation of phlebotomy devices with engineered sharps injury protection (ESIP), the impact of various winged device designs on blood splatter occurring during venipuncture procedures has not been explored. To evaluate the potential for blood splatter of 6 designs of winged phlebotomy devices. A laboratory-based device evaluation without human subjects, using a simulated patient venous system. We evaluated 18 winged phlebotomy devices of 6 device designs by Terumo, BD Vacutainer (2 designs), Greiner, Smith Medical, and Kendall (designated A-F, respectively). Scientific filters were positioned around the devices and weighed before and after venipuncture was performed. Visible blood on filters, exam gloves, and devices and measurable blood splatter were the primary units of analysis. The percentages of devices and gloves with visible blood on them and filters with measurable blood splatter ranged from 0% to 20%. There was a statistically significant association between device design and visible blood on devices ([Formula: see text]) and between device design and filters with measurable blood splatter ([Formula: see text]), but not between device design and visible blood on gloves. A wide range of associations were demonstrated between device design and visible blood on gloves or devices and incidence of blood splatter. The results of this evaluation suggest that winged phlebotomy devices with ESIP may produce blood splatter during venipuncture. Reinforcing the importance of eye protection and developing a methodology to assess ocular exposure to blood splatter are major implications for healthcare personnel who use these devices. Future studies should focus on evaluating different designs of intravascular devices (intravenous catheters, other phlebotomy devices) for blood splatter.

VACUETTE® for burn depth assessment – A simple and novel alternative use for a ubiquitous phlebotomy device

The depth of any burn wound is an important determinant of its management and outcome. It also governs the outcome of wound healing and scarring making initial depth assessment extremely vital. Various methods both invasive and non-invasive have been described in literature for burn depth estimation.We describe a useful adjunct to clinical burn depth assessment, a VACUETTE® venous blood sampling device. This single cheap, ubiquitous and sterile device usually used for phlebotomy allows subjective assessment of the most useful parameters in the assessment of burn wounds, including, capillary refill, evaluation of sensation to blunt and sharp stimuli including pain.

An evaluation of sharp safety blood evacuation devices

This article describes an evaluation of three sharp safety blood evacuation devices in seven Welsh NHS boards and the Welsh Blood Service. Products consisted of two phlebotomy needles possessing safety shields and one phlebotomy device with wings, tubing and a retractable needle. The device companies provided the devices and appropriate training. Participating healthcare workers used the safety device instead of the conventional device to sample blood during the evaluation period and each type of device was evaluated in random order. Participants filled in a questionnaire for each type of device and then a further questionnaire comparing the two shielded evacuation needles with each other Results showed that responses to all three products were fairly positive, although each device was not liked by everyone who used it. When the two shielded evacuation devices were compared with each other, most users preferred the device with the shield positioned directly above the needle to the device with the shield at the side. However, in laboratory tests, the preferred device produced more fluid splatter than the other shielded device on activation.

Conventional and sharp safety devices in 6 hospitals in British Columbia, Canada

Reengineered sharp safety devices have been recommended to reduce occupational percutaneous injury risk in health care facilities. We conducted this study just over 1 year after passage of legislation requiring the use of sharp safety medical devices to assess the frequency of safety and conventional sharp device use and whether safety features were being activated to cover sharp points after safety devices were used and before disposal. Approximately equal numbers of sharps disposal containers from various wards in 6 nonprofit adult and pediatric British Columbia hospitals were audited by paired research assistants, wearing protective clothing. In the 699 audited sharps containers, 7% (1,690/25,910) of all devices were conventional devices, specifically 2% (96/4,702) of all phlebotomy devices, 7% (1,240/17,705) of all syringes, and 10% (354/3,503) of all intravenous catheters. In addition, 94% (4,344/4,602) of all safety phlebotomy devices, 95% (2,955/3,119) of all safety intravenous devices, and 80% (13,050/16,420) of all safety syringes had been activated before disposal. More than 1 year after legislation was passed mandating the use of sharp safety devices in British Columbia hospitals, the risk from sharps remains excessive because of the ongoing use of conventional sharp devices and nonactivation of safety devices.

Cadmium, chromium, lead, manganese and nickel concentrations in blood of women in non-polluted areas in Japan, as determined by inductively coupled plasma-sector field-mass spectrometry

Background levels of metals of toxicological or industrial importance have been reported for several populations in the world. The information on the levels of metals of industrial, occupational or clinical importance in blood of general Japanese populations is however still scarce. The objectives of the study were to establish background levels of Cd, Cr, Mn, Ni and Pb in blood of Japanese population using inductively coupled plasma-sector field mass spectrometry (ICP-SF-MS), which was expected to be sensitive enough to measure low-level Pb in blood of general populations. For this purpose, women, rather than men, were studied to minimize the effect of smoking. An additional objective was to examine possible contamination from devices in phlebotomy process. Blood samples were collected in 2000's from 1,420 adult women in eight prefectures of no known anthropogenic environmental metal pollution in Japan, and the samples were subjected to ICP-SF-MS analyses after wet digestion with extra-pure nitric acid. Ultra pure water samples aspirated into blood sampling vacuum tubes were analyzed to detect possible metal contamination. Contamination of blood samples from phlebotomy device was detected for Cr and possibly for Mn and Ni, whereas it was below measurable levels with regard to Cd, Ni and Pb. Under this limitation, GM metal concentrations in blood were 1.23 μg/l for Cd, 0.55 μg/l for Cr, 13.2 μg/l for Mn, 1.81 μg/l for Ni and 15.8 μg/l for Pb. Cd and Pb tended to increase in association with age, whereas Cr, Mn and Ni tended to decrease. Smoking induced elevation both in Cd and in Pb in blood. It was also made clear that the ICP-SF-MS is reliable for measurements of Cd, Mn and Pb in blood allowing evaluation even on an individual basis, while the results of Cr and Ni should be reliable on a group basis (e.g., n ≥ 5). Limitation in compatibility was discussed between the results by ICP-SF-MS and that by traditional graphite furnace atomic absorption spectrometry. ICP-SF-MS is a reliable method of blood analysis for Cd, Mn and Pb even for the evaluation on an individual basis. Cr and Ni analyses should be reliable on a group basis, probably due to limited performance inherent to the analysis principle and matrix. Possible contamination from phlebotomy devices with Cr should be taken into account in evaluating the results.

Comparison of Laboratory Values Obtained by Phlebotomy versus Saline Lock Devices

Comparison of Laboratory Values Obtained by Phlebotomy versus Saline Lock Devices

Comparison of Laboratory Values Obtained by Phlebotomy vs. Saline Lock Devices

Comparison of Laboratory Values Obtained by Phlebotomy vs. Saline Lock Devices

Costs and benefits of measures to prevent needlestick injuries in a university hospital.

To document the costs and the benefits (both in terms of costs averted and of injuries averted) of education sessions and replacement of phlebotomy devices to ensure that needle recapping did not take place. The percentage of recapped needles and the rate of needlestick injuries were evaluated in 1990 and 1997, from a survey of transparent rigid containers in the wards and at the bedside and from a prospective register of all injuries in the workplace. Costs were computed from the viewpoint of the hospital. Positive costs were those of education and purchase of safer phlebotomy devices; negative costs were the prophylactic treatments and follow-up averted by the reduction in injuries. A 1,050-bed tertiary-care university hospital in the Paris region. Between the two periods, the proportion of needles seen in the containers that had been recapped was reduced from 10% to 2%. In 1990, 127 needlestick (12.7/100,000 needles) and 52 recapping injuries were reported versus 62 (6.4/100,000 needles) and 22 in 1996 and 1997. When the rates were related to the actual number of patients, the reduction was 76 injuries per year. The total cost of information and preventive measures was $325,927 per year. The cost-effectiveness was $4,000 per injury prevented. Although preventive measures taken to ensure reduction of needlestick injuries appear to have been effective (75% reduction in recapping and 50% reduction in injuries), the cost of the safety program was high.

Needlestick Injury Rate Reduction During Phlebotomy: A Comparative Study of Two Safety Devices

Vanderbilt University Medical Center's Lab Liaison Services evaluated two phlebotomy devices designed to reduce needlestick injuries in phlebotomy. Analysis during the 17- month evaluation period showed the rate of needlestick injuries using a standard phlebotomy device was 28 injuries per 100 employees, use of a recapping device decreased the rate to 26 injuries per 100 employees, and use of a needle-sheathing device that eliminates recapping and disassembly reduced the rate to only five injuries per 100 employees. This represents an 82% reduction in the needlestick injury rate. The use of a needlesheathing device eliminated all recapping, disassembly, and disposal injuries. The dramatic reduction of needlestick injuries has led to a safer working environment for laboratory employees.

History of Transfusion and Phlebotomy Devices

History of Transfusion and Phlebotomy Devices