Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T09:51:26.648Z Has data issue: false hasContentIssue false

Contribution of a Winged Phlebotomy Device Design to Blood Splatter

Published online by Cambridge University Press:  02 January 2015

Donna J. Haiduven*
Affiliation:
Veterans Administration Health Services Research and Development/Rehabilitation Research and Development Research Center of Excellence, Tampa, Florida Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida
Christine McGuire-Wolfe
Affiliation:
Veterans Administration Health Services Research and Development/Rehabilitation Research and Development Research Center of Excellence, Tampa, Florida Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida
Shawn P. Applegarth
Affiliation:
Veterans Administration Health Services Research and Development/Rehabilitation Research and Development Research Center of Excellence, Tampa, Florida
*
Department of Global Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, FL 33612 ([email protected])

Abstract

Background.

Despite a proliferation of phlebotomy devices with engineered sharps injury protection (ESIP), the impact of various winged device designs on blood splatter occurring during venipuncture procedures has not been explored.

Objectives.

To evaluate the potential for blood splatter of 6 designs of winged phlebotomy devices.

Design.

A laboratory-based device evaluation without human subjects, using a simulated patient venous system.

Methods.

We evaluated 18 winged phlebotomy devices of 6 device designs by Terumo, BD Vacutainer (2 designs), Greiner, Smith Medical, and Kendall (designated A-F, respectively). Scientific filters were positioned around the devices and weighed before and after venipuncture was performed. Visible blood on filters, exam gloves, and devices and measurable blood splatter were the primary units of analysis.

Results.

The percentages of devices and gloves with visible blood on them and filters with measurable blood splatter ranged from 0% to 20%. There was a statistically significant association between device design and visible blood on devices (P< .0001) and between device design and filters with measurable blood splatter (P< .0001), but not between device design and visible blood on gloves. A wide range of associations were demonstrated between device design and visible blood on gloves or devices and incidence of blood splatter.

Conclusions.

The results of this evaluation suggest that winged phlebotomy devices with ESIP may produce blood splatter during venipuncture. Reinforcing the importance of eye protection and developing a methodology to assess ocular exposure to blood splatter are major implications for healthcare personnel who use these devices. Future studies should focus on evaluating different designs of intravascular devices (intravenous catheters, other phlebotomy devices) for blood splatter.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Needlestick Safety and Prevention Act. Pub L No. 104–130. H.R. 5178 (2000).Google Scholar
2.Occupational exposure to blood borne pathogens: needle stick and other sharps injuries; final rule 2001. Occupational Safety and Health Administration website. http://www.osha.gov/SLTC/bloodbornepathogens/standards.html. Published 2001. Accessed December 21, 2011.Google Scholar
3.Haiduven, DJ, Applegarth, SP, Shroff, MP. An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices. Am J Infect Control 2009;37:127130.CrossRefGoogle ScholarPubMed
4.Haiduven, DJ, Applegarth, SP, Shroff, MP, Thompson, VP. Detecting blood splatter from retractable phlebotomy and intravascular devices: an experimental method [abstract]. Am J Infect Control 2007;35:E165166.CrossRefGoogle Scholar
5.Rosen, HR. Acquisition of hepatitis C by a conjunctival splash. Am J Infect Control 1997;25:242247.CrossRefGoogle ScholarPubMed
6.Sartori, M, La Terra, G, Aglietta, M, Manzin, A, Navino, C, Verzetti, G. Transmission of hepatitis C via blood splash into conjunctiva. Scand J Infect Dis 1993;25:270271.CrossRefGoogle ScholarPubMed
7.Hosoglu, S, Celen, MK, Akalin, S, Geyik, MF, Soyoral, Y, Kara, IH. Transmission of hepatitis C by blood splash into conjunctiva in a nurse. Am J Infect Control 2003;31:502504.CrossRefGoogle ScholarPubMed
8.Taylor, JD. AIDS and hepatitis B and C: contamination risk at transurethral resection: a study using sodium fluorescein as a marker. Med J Aust 1990;153:257260.CrossRefGoogle Scholar
9.Miller, CD, Songer, JR, Sullivan, JF. A twenty-five year review of laboratory-acquired human infections in the National Animal Disease Center. Am Ind Hyg Assoc J 1987;48:271275.CrossRefGoogle ScholarPubMed
10.Sewell, DL. Laboratory-associated infections and biosafety. Clin Microbiol Rev 1995;8(3):389405.CrossRefGoogle ScholarPubMed
11.United States Public Health Service. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Recomm Rep 2001;50(RR-11):152.Google Scholar
12.Workbook for designing, implementing, and evaluating a sharps injury prevention program. Centers for Disease Control and Prevention website. http://www.cdc.gov/sharpssafety/index.html. Published 2008. Accessed March 16, 2012.Google Scholar
13.Safety feature evaluation forms. Training for Development of Innovative Control Technologies (TDICT) Project website. http://www.tdict.org/evaluation2.html. Published 1990. Accessed December 21, 2011.Google Scholar
14.Simpkins, S, Haiduven, DJ, Stevens, DA. Safety product evaluation: six years of experience. Am J Infect Control 23(5):317322.CrossRefGoogle Scholar
15.Ford, J, Phillips, MR. How to evaluate sharp safety engineered devices. Nurs Times 2008;104(36):4245.Google ScholarPubMed
16.Ogendo, SW, Awori, MN, Omondi, MA, Mulatya, EM, Mugo, PW. Risk of conjunctival contamination from blood splashes during surgery at the Kenyatta National Hospital, Nairobi. East Afr Med J 2008;85(9):432437.CrossRefGoogle ScholarPubMed
17.Collins, D, Rice, J, Nicholson, P, Barry, K. Quantification of facial contamination with blood during orthopedic procedures. JHosp Infect 2000;45(1):7375.Google Scholar
18.Prior, AJ, Montgomery, PQ, Srinivasan, V. Eye protection in ear, nose and throat surgery. J Otolaryngol 1993;107(7):618619.Google ScholarPubMed
19.McWilliams, RG, Blanshard, KS. The risk of blood contamination during angiography. Clin Radiol 1994;49(1):5960.CrossRefGoogle ScholarPubMed
20.Asai, T, Hidalka, I, Kawashima, A, Miki, T, Inada, K, Kawachi, S. Efficacy of catheter needles with safeguard mechanisms. Anaesthesia 2002;57:572577.CrossRefGoogle ScholarPubMed
21.Ford, J, Phillips, MR. An evaluation of sharp safety blood evacuation devices. Nurs Stand 2011;25(43):4147.CrossRefGoogle ScholarPubMed