Tips on the Conversion to Single Use Blood-Draw Hubs
By Michael Garvin, MHA
The National Phlebotomist Association (www.phlebotomy.org) strongly recommends that healthcare professionals who collection blood specimens should use a single-use blood-draw set. The Occupational Safety and Health Administration (OSHA) agrees that healthcare organizations should purchase single-use blood-draw hubs. The conversion to single-use blood-draw hubs affects hospitals, clinics and physician offices in a number of ways.
First, the conversion will impact healthcare clinicians who are used to carrying around a tray on which sits a needle disposal container. This allows that person to detach the needle from the multi-use blood-draw hub. With the conversion to single-use devices, all blood-draw sets will need to be placed in a sharps disposal container. Secondly, the conversion will negatively impact the efforts by the facility to reduce its amount of infectious waste.
In the late 1990s, the American Hospital Association (AHA) and the U.S. Environmental Protection Agency (EPA) signed a joint letter of agreement, detailing a commitment that the healthcare industry would reduce the amount of infectious waste generated by 50 percent by 2003. The conversion to single-use blood-draw sets will negatively impact a facility's effort to reduce waste volumes. Thirdly, a conversion will negatively impact hospital's budgets in that facilities will have to not only pay more for blood draw sets but will have to purchase more sharps disposal boxes.
One way to meet both the commitment to regulatory compliance as well as being a solid environmental citizen is to not include the single-use hub as infectious waste. The safety feature activated needle would have to be disposed of in a sharps disposal box but the hub would not meet the criteria of infectious waste.
The standard definition of infectious waste is that the waste item is saturated with blood or other potentially infectious body fluid to a point that it would drip if compressed. This is not the case of the blood-draw set hub. The needle can be covered with the safety feature and then the needle assembly can be detached using a needle disposal box that is designed with a "grip and drop" slot. This way the backside of the needle is never exposed so an injury cannot happen. The hub can then be placed in a regular waste container without any violation of safety or waste regulation.
If a facility decides to implement this approach to managing the single-use blood-draw conversion, it is strongly recommended that a document be written explaining the rationale and procedure. The document should include:
- A rationale statement that make note of the facility's effort to satisfy both the need to employee and patient safety as well as respecting a commitment to its environmental obligations;
- A statement that there is no other way to meet both safety and environment commitments other than to have the staff safely remove the covered needle from the holder with a "grip and drop" slot on the needle disposal container;
- A statement that the back-side needle is never exposed; and
- A statement that sharps injuries involving blood-draw devices will be review to ensure that a high level of safety is maintained at all times.