Infection Control Today - 03/2004: Healthcare Professionals

March 1, 2004

Healthcare Professionals Settle on Simple But Effective Safety Solutions

By Michael Garvin, MHA

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

A Simple Solution to a Complicated Problem

Many of the most popular safety medical devices on the marketuse a living hinge technology. This living hinge system did not alwaysexist; it was actually introduced to the market by a fairly small company on theEast Coast. Today, most of the major medical supply manufacturing companiesoffer some version of the living hinge. Probably the most important breakthrough was the fact that thedevice, for the first time in medical-device design, allowed for the safetyfeature to be incorporated into the needle and not the hub or syringe base. Thatsingle development allowed for safety devices to be interchangeable. A safetyhinged needle manufactured by one company could be used with a syringe hub madeby another. This compatibility was a welcome change to clinicians. Medicationscould be drawn up with a standard needle and a safety needle could be usedduring the administration of the medication. Syringes were packaged separatelyfrom the safety needle. Clinicians appreciated not having needles packaged withthe syringe hub especially with the increasing number of times that clinicianshave to use the syringe hubs in an IV push situation where the needle is notnecessary.

Safety Devices Impact Workforce Issues

The living hinge design also was the first technologicalbreakthrough that focused on the growing concern for making training of the useof safety simpler. To do that, the designer had to make the tasks in activatingthe safety feature very easy to do. The living hinge design was very easy toactivate. In some cases, the manufacturer asked the user to activate the safetyhinge on a hard surface. In other cases, the clinician was asked to use theirthumb to activate the safety hinge. In either case, the activation of the safetyfeature involved very few steps. Use of the devices was almost intuitive, sothat training took a very short amount of time. This is critically important toclinician managers because the less amount of training required for new staff,the better. Staff members who work in several places around a hospital did nothave 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 wherethey are dispersed. This poses a safety challenge for clinicians. Most of thehinged device products have a transport mode that allows the hinged safetycover to cover the needle tip while the syringe is being transported, but theneedle 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 wayas to minimize the possibility that the cover could get in the way during theinjection. The bevel should always be facing up toward the hinge cover side. This allows for the cover to always be perpendicular to theplane of the injection site.

There is still discussion whether the cover itself should beclear to allow some vision through it or whether it should have color so that itstands 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 safetyneedles, have served the healthcare industry very well. They have allowed for aseparation between the syringe and needle in regard to safety design. They haveallowed for the production of a device that can be easily understood inreference to training. They have provided the means for the healthcare industryto achieve a higher standard of safety for its workers.

Michael Garvin, MHA, is a former safety and healthprofessional at the University of Iowa and the University of Wisconsin. He iscurrently chief operations officer for education provider AudioNetInternational.