Tips on the Conversion to Single Use Blood-Draw Hubs

May 1, 2002

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.