Infection Control Today - 03/2004: Healthcare Professionals

Healthcare Professionals Settle on Simple But Effective Safety Solutions

By Michael Garvin, MHA

Hospital health and safety professionals have made large strides in introducing safety devices into the healthcare setting. In doing so, the numbers of sharps-related injuries have declined steadily over the past five years. No one knows for sure what year healthcare clinicians fully embraced safety devices, and no one can tell at what point in time safety devices became the norm rather than the exception. Yet there seems to be some level of agreement as to the technological breakthrough involved in the universal acceptance of sharps-safety devices. It is much like that point in time when Henry Ford figured out how to make a car that was inexpensive but worked very well. The healthcare safety industry went through a similar watershed moment for safety medical devices.

A Simple Solution to a Complicated Problem

Many of the most popular safety medical devices on the market use a living hinge technology. This living hinge system did not always exist; it was actually introduced to the market by a fairly small company on the East Coast. Today, most of the major medical supply manufacturing companies offer some version of the living hinge. Probably the most important breakthrough was the fact that the device, for the first time in medical-device design, allowed for the safety feature to be incorporated into the needle and not the hub or syringe base. That single development allowed for safety devices to be interchangeable. A safety hinged needle manufactured by one company could be used with a syringe hub made by another. This compatibility was a welcome change to clinicians. Medications could be drawn up with a standard needle and a safety needle could be used during the administration of the medication. Syringes were packaged separately from the safety needle. Clinicians appreciated not having needles packaged with the syringe hub especially with the increasing number of times that clinicians have to use the syringe hubs in an IV push situation where the needle is not necessary.

Safety Devices Impact Workforce Issues

The living hinge design also was the first technological breakthrough that focused on the growing concern for making training of the use of safety simpler. To do that, the designer had to make the tasks in activating the safety feature very easy to do. The living hinge design was very easy to activate. In some cases, the manufacturer asked the user to activate the safety hinge on a hard surface. In other cases, the clinician was asked to use their thumb to activate the safety hinge. In either case, the activation of the safety feature involved very few steps. Use of the devices was almost intuitive, so that training took a very short amount of time. This is critically important to clinician managers because the less amount of training required for new staff, the better. Staff members who work in several places around a hospital did not have to be re-trained to move to other areas.

Transporting and Using Safety Syringes in a Safe Manner

Medications are rarely drawn up in the same location as where they are dispersed. This poses a safety challenge for clinicians. Most of the hinged device products have a transport mode that allows the hinged safety cover to cover the needle tip while the syringe is being transported, but the needle can be uncovered once the injection needs to be given.

In the next major development with most of the hinged devices, is that companies agreed that the needle bevel should be oriented in such a way as to minimize the possibility that the cover could get in the way during the injection. The bevel should always be facing up toward the hinge cover side. This allows for the cover to always be perpendicular to the plane of the injection site.

There is still discussion whether the cover itself should be clear to allow some vision through it or whether it should have color so that it stands out from the rest of the device. That is largely a clinical preference. Both arguments have merit.

In the final analysis, safety devices, like the hinged safety needles, have served the healthcare industry very well. They have allowed for a separation between the syringe and needle in regard to safety design. They have allowed for the production of a device that can be easily understood in reference to training. They have provided the means for the healthcare industry to achieve a higher standard of safety for its workers.

Michael Garvin, MHA, is a former safety and health professional at the University of Iowa and the University of Wisconsin. He is currently chief operations officer for education provider AudioNet International.

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