Retractable Syringes Research Articles

Retractable Syringes in a Swiss Prison Needle and Syringe Exchange Program: Experiences of Drug-using Inmates and Prison Staff Perceptions

Needle and Syringe Exchange Programs (NSP) prevent infectious diseases in community and prisons. Less than 1 % of prisons worldwide have NSP. One barrier is organizational concern for needle stick injuries from used syringes. Given these concerns, we introduced retractable syringes into our prison NSP and evaluated 1) injection drug users’ experiences with retractable syringes and 2) beliefs and knowledge about NSP among prison officers (PO) and healthcare staff (HS). In 2010, we replaced usual syringes with retractable needle devices in the prison of Champ-Dollon, Geneva, Switzerland. We examined demographics, clinical profiles and NSP use among NSP participants, and asked about ease and safety of retractable syringes use in interviews. We distributed questionnaires to PO and HS, to assess knowledge and general opinions on NSP. The majority of participants expressed that retractable syringes were acceptable alternatives, but needed improvements. Of the questionnaires, 90.3 % of PO and 9.6 % of HS were still concerned about misuse of soiled syringes as weapons. Improving the quality and ease of use of use may increase the acceptance of retractable syringes. Continuing to address PO and HS safety concerns is an important step towards more disseminated NSP implementation and useful innovation.

Safety Syringes and Anti-Needlestick Devices in Orthopaedic Surgery

The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting safety-engineered devices for an orthopaedic clinic, conventional syringes larger than 20 mL and conventional needles longer than 1.5 in (3.8 cm) are necessary.

Abstract: P850 CLINICAL AND PARA CLINICAL CHARACTERISTIC OF PATIENTS WITH M I

A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals.Questionnaires were distributed in 52 hospitals to a stratified random sample of 2118 (46.3%) nurses between April and September 2005 to collect self-reported NSI in the past 12- months.Of the 1555 nurses who returned a completed questionnaire, 49.6% (95% confidence interval [95 CI] 47.1%–52.1%) recalled at least one sharps injury, of which 52.6% were classified as NSI. Just over one fourth (26.3%; 95 CI 24.1%–28.6%, 409/1555) of respondents sustained at least one NSI, 75.6% (95 CI 71.1%–79.6%) recalled having sustained between 1 and 4 injuries in the past 12-months, of which 72.2% involved a hollow-bore needle and 95.1% of injuries involved fingers. Predictors of NSI included being a registered nurse (odds ratio [OR] 1.6, 95% CI 1.1–2.3) or midwife (OR 2.4, 95% CI 1.4–3.9) compared with nurse managers, being employed in a hospital located in other cities smaller than Shiraz (OR 1.4, 95% CI 1.1–1.8). Nurses who reported a previous contaminated NSI were less likely to sustain a further injury (OR 0.3, 95% CI 0.2–0.4).The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic.

The Ergonomics of Retraction: A Comparison of Two Brands of Retractable Syringes

The Ergonomics of Retraction: A Comparison of Two Brands of Retractable Syringes

Needlestick injuries in a major teaching hospital: The worthwhile effect of hospital-wide replacement of conventional hollow-bore needles

Needlestick injury (NSI) with hollow-bore needles remains a significant risk of bloodborne virus acquisition in health care workers. The impact on NSI rates after substantial replacement of conventional hollow-bore needles with the simultaneous introduction of safety-engineered devices (SEDs) including retractable syringes, needle-free intravenous (IV) systems, and safety winged butterfly needles was examined in an 800-bed Australian university hospital. NSIs were prospectively monitored for 2 years (2005-2006) after the introduction of SEDs and compared with prospectively collected preintervention NSI data (2000-2004). Preintervention hollow-bore NSI rates over 10 years persisted at a constant rate between 3.01 and 3.77 per 100 full-time equivalent employees (FTE) (P = .31). Rates for 2005 (1.93; 95% CI: 1.48-2.47 per 100 FTE) and 2006 (1.50; 95% CI: 1.11-1.97 per 100 FTE) were significantly lower than the average rate for the preintervention years (3.39; 95% CI: 2.7-4.24 per 100 FTE, P = .00004). This represents a fall of 49% (43.1%-55.7%) in hollow-bore NSI, contributed to by the virtual elimination of NSI related to accessing IV lines. More importantly, high-risk injuries were also reduced 57% by retractable syringe use with an overall budgetary increase of approximately US $90,000 per annum. Introduction of SEDs results in an impressive fall in NSI with minimal cost outlay.

Needlestick Injuries Among Nurses of Fars Province, Iran

A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals. Questionnaires were distributed in 52 hospitals to a stratified random sample of 2,118 (46.3%) nurses between April and September 2005 to collect self-reported NSI in the past 12- months. Of the 1,555 nurses who returned a completed questionnaire, 49.6% (95% confidence interval [95 CI] 47.1%-52.1%) recalled at least one sharps injury, of which 52.6% were classified as NSI. Just over one fourth (26.3%; 95 CI 24.1%-28.6%, 409/1,555) of respondents sustained at least one NSI, 75.6% (95 CI 71.1%-79.6%) recalled having sustained between 1 and 4 injuries in the past 12-months, of which 72.2% involved a hollow-bore needle and 95.1% of injuries involved fingers. Predictors of NSI included being a registered nurse (odds ratio [OR] 1.6, 95% CI 1.1-2.3) or midwife (OR 2.4, 95% CI 1.4-3.9) compared with nurse managers, being employed in a hospital located in other cities smaller than Shiraz (OR 1.4, 95% CI 1.1-1.8). Nurses who reported a previous contaminated NSI were less likely to sustain a further injury (OR 0.3, 95% CI 0.2-0.4). The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic.

Polymer tribology in safety medical devices: Retractable syringes

AbstractWe analyze an example of the application of polymer tribology to create a safety medical device, namely a retractable syringe. In service at various stages either low‐ or high‐dynamic friction is needed. Our work focuses on a VanishPoint® nonreusable safety syringe manufactured by Retractable Technologies, Inc., Little Elm, TX. Different medical‐grade materials strongly affect the performance of this product. Extant tribological testing methods developed for flat surfaces are of little use. A functionality test that provides static and dynamic friction between rounded and cylindrical parts moving one inside the other gives us data not obtainable from the earlier techniques. These results combined with the liquid blowout force results (also for cylindrical surfaces) tell us that a polyolefin elastomer imparts better properties to a polypropylene‐containing resin than does silica as an additive. Data‐based selection of appropriate polymeric materials for components of the syringe thus becomes possible. © 2007 Wiley Periodicals, Inc. Adv Polym Techn 26:56–64, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20084

A pilot study to measure the compressive and tensile forces required to use retractable intramuscular safety syringes

A pilot study was conducted at the Tampa Veterans Administration Patient Safety Center. The objective was to determine the forces required to operate retractable safety syringes to evaluate potential adverse occupational health and patient safety issues. Four brands (100 each) of retractable syringes were tested, using a digital force gauge, in air and in a simulated patient material (SPM). Compressive and tensile forces were measured while activating the retraction mechanism and withdrawing saline into the syringe barrel, respectively. The mean compressive force was greater in SPM than in air in all 4 devices. There was a statistically significant compressive force difference between activation in air and SPM in devices 1 and 2 (P </= .05). The tensile forces for all devices were lower than the compressive forces. Analysis of variance was used to compare the groups, and the results showed that the means were significantly different (P < .001). This pilot study has implications for device selection, training for users, design issues for manufacturers, and patient safety, as well as potential for future needlestick and ergonomic injuries. We recommend replication of this study with a computer-controlled force testing apparatus, and by testing multiple needle and syringe sizes.

A Pilot Study To Measure the Compressive and Tensile Forces Required To Use Retractable Intramuscular Safety Syringes

BACKGROUND/OBJECTIVES: Even though retractable intramuscular safety syringes are designed to be activated while still in the patient's muscle or subcutaneous tissue, there are reports of healthcare workers activating these devices outside of the patient. This may be due to perceptions that the force required to activate the retraction mechanism may cause added discomfort to the patient. If such concerns could be substantiated, the possibility for a sharps injury still exists if these safety devices are not utilized correctly, in essence defeating their intended purpose. The objective of this pilot study was to determine the forces required to operate retractable safety syringes in order to evaluate potential adverse occupational health and patient safety issues. METHODS: A newly-developed product evaluation laboratory at the James A. Haley Veterans Administration Patient Safety Center in Tampa, Florida, provided the controlled setting for evaluating safer needle devices in this pilot study. Four brands (100 each) of retractable syringes were tested, using a digital force gauge, in air and in a simulated patient material (SPM). Compressive forces were measured while activating the retraction mechanism in both air and SPM. Tensile forces were measured while withdrawing 2 cc of saline into the syringe barrel. Two-way analysis of variance and Duncan's Multiple Range test were used in the statistical analysis. RESULTS: The compressive forces demonstrated by the four devices in both air and SPM measured from a low of 0.52 lbs to a high of 22.02 lbs (range = 21.97 lbs). The mean compressive force was greater in SPM than in air in all four devices. There was a statistically significant compressive force difference between activation in air and SPM in devices 1 and 2 (p ≤ 0. 05). The tensile forces measured from a low of 0.06 lbs to a high of 2.18 lbs (range = 2.12 lbs). The tensile forces for all devices were lower than the compressive forces. Analysis of variance demonstrated a significant difference between the means of the four tensile groups (p < 0.001). CONCLUSIONS: There was considerable variability in the measured compressive force between devices yet the compressive force was still greater in SPM than in air. The results of this pilot study pose needlestick injury potential and device training issues for healthcare workers, as well as possible future impacts on the design of this type of safety device. The cumulative ergonomic effects of compressive and tensile forces require further investigation. Replication of this study by multiple researchers, using numerous needles and syringe sizes, is recommended.

An Evaluation of Potential Liquid/Aerosol Releases from a New Retractable Syringe

This study evaluated potential liquid and/or aerosol release from the use of a retractable syringe designed to prevent accidental needlesticks. This device includes a mechanism that retracts the needle into the syringe barrel upon depression of the plunger. During activation, the possibility exists for the release of blood and/or drug solution. The syringe was tested using radiolabeled bovine serum albumin (125I) to simulate human blood and tritiated water (3H) to simulate a drug solution, allowing for the quantification of potential releases. Blood release as a result of the retraction mechanism was not detected, but indications of a simulated drug release were. The quantity of the simulated drug release was directly proportional to the gauge size of the needle and was unaffected by the syringe size. Users of this product might be cautioned against the possibility of a drug release when activating the needle retraction mechanism.

Healthcare Workers And Needlesticks

Healthcare Workers And Needlesticks