JOURNAL LITERATURE – LIST and ABSTRACTS
The following list of journal articles pertains to the review, selection, testing, or evaluation of safer needle devices. This list is not meant to be definitive or exhaustive; as new devices are released new articles can be expected to be published. An analysis of detailed information is provided in a tabular format in the related file titled: sharps-journal-lit-analysis-08-05.xls (229 KB)
Abstracts corresponding to the list number immediately follow.
Adams, KS, Zehrer, C. L., & Thomas, W. Comparison of a needleless system with conventional heparin locks. American Journal of Infection Control 1993 Oct;21: (263-269).
Adams T, McCleary J, Caldero K. Guarded fistula needle reduces needlestick injuries in hemodialysis. Nephrol News Issues 2002 May;16(6):66-70, 72.
Alvarado-Ramy F, Beltrami EM, Short LJ, Srivastava PU, Henry K, Mendelson M, Gerberding JL, Delclos GL, Campbell S, Solomon R, Fahrner R, Culver DH, Bell D, Cardo DM, Chamberland ME. A Comprehensive Approach to Percutaneous Injury Prevention During Phlebotomy: Results of a Multicenter Study, 1993–1995. Infect Control Hosp Epidemiology 2003 Feb;24(2):97-104.
Asia T, Matsumoto S, Matsumoto H, Yamamoto K, Shingu K. Prevention of needle-stick injury. Efficacy of a safeguarded intravenous cannula. Anaesthesia 1999 Mar; 54(3):258-261.
Babcock HM, Fraser V. Differences in Percutaneous Injury Patterns in a Multi-Hospital System. Infect Control Hosp Epidemiology 2003 Oct;24(10):731-736.
Beason R, Bourguignon J, Fowler D, Gardner C. Evaluation of a needle-free intravenous access system. J Intraven Nursing 1992 Jan-Feb;15(1):11-6.
Bebbington MW, Treissman MJ. The use of a surgical assist device to reduce glove perforations in post delivery vaginal repair: a randomized controlled trial. Am J Obstet Gynecology 1996 Oct;175(4 Pt 1):862-6.
Center for Disease Control and Prevention. (1997). Evaluation of Blunt Suture Needles in Preventing Percutaneous Injuries Among Health-Care Workers During Gynecologic Surgical Procedures - New York City, March 1993 - June 1994. Morbidity and Mortality Weekly Report, 46(2), (25-28).
Center for Disease Control and Prevention. (1997). Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health-Care Workers During Phlebotomy Procedures-Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995. Morbidity and Mortality Weekly Report, 46(2), (21-25).
Chiarello, LA. Selection of Needlestick prevention devices: A conceptual framework for approaching product evaluation. American Journal of Infection Control 1995 Dec;23(6):386-95.
Clarke SP, Sloane DM, Aiken LH. Needlestick injuries to nurses, in context. LDI Issue Brief 2002 Sep;8(1):1-4.
Crnich CJ, Maki DG. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices. Clinical Infectious Disease. 2002 May 1;34(9):1232-42.
Crnich CJ, Maki DG. The promise of novel technology for the prevention of intravascular device-related bloodstream infection. II. Long-term devices. Clinical Infectious Disease. 2002 May 15;34(10):1362-8.
Dale JC, Pruett SK, Maker MD. Accidental needlestick in the Phlebotomy Service of the Department of Laboratory Medicine and Pathology at Mayo Clinic Rochester. Mayo Clin Proc 1998 Jul;73(7):611-5.
Doebbeling BN, Vaughn TE, McCoy KD, Beekmann SE, Woolson RF, Ferguson KJ, Torner JC. Percutaneous Injury, Blood Exposure, and Adherence to Standard Precautions: Are Hospital-Based Health Care Providers Still at Risk? CID 2003 Oct;37:10006-13.
Edmond M, Khakoo R, McTaggart B, Solomon R. Effect of bedside needle disposal units on needle recapping frequency and needlestick injury. Infect Control Hosp Epidemiology 1988 Mar;9(3):114-6.
Fan ST, Teoh-Chan CH, Lau KF, Chu KW, Kwan AK, Wong KK. Predictive value of surveillance skin and hub cultures in central venous catheters sepsis. J Hosp Infect. 1988 Oct;12(3):191-8.
Gershon RR, Pearse L, Grimes M, Flanagan PA, Vlahov D. The impact of multifocused interventions on sharps injury rates at an acute-care hospital. Infect Control Hosp Epidemiology 1999 Dec;20(12):806-11.
Gillen, M, McNary J, Lewis J, Davis M, Boyd A, Schuller M, Curran C, Young CA, Cone J. Sharps-Related Injuries in California Healthcare Facilities: Pilot Study Results From the Sharps Injury Surveillance Registry. Infection Control and Hospital Epidemiology 2003;24:113-121.
Grimmond T, Rings T, Taylor C, Creech R, Kampen R, Kable W, Mead P, Mackie P, Pandur R. Sharps injury reduction using Sharpsmart--a reusable sharps management system. J Hosp Infect. 2003 Jul;54(3):232-8.
Haiduven DJ, DeMaio TM, Stevens DA. A five-year study of needlestick injuries: significant reduction associated with communication, education, and convenient placement of sharps containers. Infect Control Hosp Epidemiology 1992 May;13(5):265-71.
Haiduven DJ, Phillips ES, Clemons KV, Stevens DA. Percutaneous injury analysis: consistent categorization, effective reduction methods, and future strategies. Infect Control Hosp Epidemiology 1995 Oct;16(10):582-9.
Hanrahan A, Reutter L. A review of the literature on sharps injuries: epidemiology, management of exposures and prevention. J Adv Nurs 1997 Jan;25(1):144-54.
Ippolitto G, De Carli G, Puro V, Petrosillo N, Arici C, Bertucci R, Bianciardi L, Bonazzi L, Cestrone A, Daglio M, Perna M, Pietrobon F, & Jagger J. Device-Specific Risk of Needlestick Injury in Italian Health Care Workers. JAMA 1994 Aug 24-31;272(8):607-10.
Jackson EM, Wenger MD, Neal JG, Thacker JG, Edlich RF. Inadequate Standard for Glove Puncture Resistance: Allows Production of Gloves with Limited Puncture Resistance. The Journal of Emergency Medicine 1998 May-Jun;16(3):461-5.
Jagger J, Hunt EH, Brand-Elnaggar J, Pearson RD. Rates of needle-stick injury caused by various devices in a university hospital. New England Journal of Medicine 1988 Aug 4;319(5):284-8.
Jagger J, Hunt EH, & Pearson RD. Sharp object injuries in the hospital: Causes and strategies for prevention. American Journal of Infection Control 1990 Aug;18(4):227-31.
Jeanes, A. Zero-Stik Safety Syringe: an automatic safety syringe. Br J Nurs 1999 Apr 22-Mar 12;8(8):530-1, 534-5
Kempen, PM. Assessing Blunt Cannulae as Replacements for Hypodermic Needles During Intravenous Therapy: Safety and Utility. Infection Control and Hospital Epidemiology 1997 Mar;18(3):169-74.
Krasinski K, LaCouture R, Holzman RS. Effect of changing needle disposal systems on needle puncture injuries. Infect Control 1987 Feb;8(2):59-62.
Laufer FN, Chiarello LA. Application of cost-effectiveness methodology to the consideration of needlestick-prevention technology. Am J Infect Control 1994 Apr;22(2):75-82.
Lawrence LW, Delclos GL, Felknor SA, Johnson PC, Frankowski RF, Cooper SP, Davidson A. The Effectiveness of a Needleless Intravenous Connection System: An Assessment by Injury Rate and User Satisfaction. Infect Control Hosp Epidemiology 1997 Mar;18(3):175-82.
L'Ecuyer PB, Schwab EO, Iademarco E, Barr N, Aton EA, Fraser VJ. Randomized Prospective Study of the Impact of Three Needleless Intravenous Systems on Needlestick Injury Rates. Infect Control Hosp Epidemiology 1996 Dec;17(12):803-8.
Linnemann CC Jr, Cannon C, DeRonde M, Lanphear B. Effect of educational programs, rigid sharps containers, and universal precautions on reported needlestick injuries in healthcare workers. Infect Control Hosp Epidemiology 1991 Apr;12(4):214-9.
Llewellyn J, Giese R, Nosek LJ, Lager JD, Turco SJ, Goodell J, Coleman J, McQuone MJ, Collier PA, Minard DA. A Multicenter Study of Costs and Nursing Impact of Cartridge-Needle Units. Nursing Economics 1994 Jul-Aug;12(4):208-14.
Mendelson M; Lin-Chen BY, Solomon R, Bailey E, Kogan G, Goldbold J. Evaluation of a Safety Resheathable Winged Steel Needle for Prevention of Percutaneous Injuries Associated With Intravascular-Access Procedures Among Healthcare Workers. Infection Control and Hospital Epidemiology 2003;24:105-112.
Mendelson M, Lin-Chen BY, Finkelstein-Blond L, Bailey E, Kogan G. Evaluation of a Safety IV Catheter (IVC) (Becton Dickinson, INSYTE™ AUTOGUARD™): Final Report. Eleventh Annual Scientific Meeting; Society for Healthcare Epidemiology of America, 2001 SHEA.
Mendelson MH, Short LJ, Schechter CB, Meyers BR, Rodriguez M, Cohen S, Lozada J, DeCambre M, Hirschman SZ. Study of a Needleless Intermittent Intravenous-Access System for Peripheral Infusions: Analysis of Staff, Patient, and Institutional Outcomes. Infection Control and Hospital Epidemiology 1998 Jun;19(6), (401-406).
Mulherin S, Rickman LS, Jackson MM. Initial Worker Evaluation of a New Safety Syringe. Infect Control Hosp Epidemiology 1996 Sep;17(9):593-4.
National Institute for Occupational Safety and Health (NIOSH). Preventing Needlestick Injuries in Health Care Settings. NIOSH Alert Publication No. 2000-108, November 1999. Website: www.cdc.gov/niosh/2000-108.htm
Orenstein, R. The benefits and limitations of needle protectors and needleless intravenous systems. J Intraven Nurs 1999 May-Jun;22(3):122-8.
Orenstein R, Reynolds L, Karabaic M, Lamb A, Markowitz SM, Wong ES. Do protective devices prevent needlestick injuries among health care workers? American Journal of Infection Control 1995 Dec;23(6):344-51.
Patel N, Tignor GH. Device-specific sharps injury and usage rates: An analysis by hospital department. American Journal of Infection Control 1997;25:77-84.
Pegues, D. Building Better Programs to Prevent Transmission of Blood-Borne Pathogens to Healthcare Personnel: Progress in the Workplace, But Still No End in Sight. Infect Control Hosp Epidemiology 2003 Oct;24(10):719-721.
Pugliese G, Germanson TP, Bartley J, Luca J, Lamerato L, Cox J, Jagger J. Evaluating sharps safety devices: Meeting OSHA’s intent. Infect Control Hosp Epidemiology 2001 Jul;22(7):456-8.
Quebbeman EJ, & Short LJ. How to Select and Evaluate New Products on the Market. Surgical Clinics of North America 1995 Dec;75(6):1159-65.
Ribner BS. An effective educational program to reduce the frequency of needle recapping. Infect Control Hosp Epidemiology 1990 Dec;11(12):635-8.
Rice JJ, McCabe JP, McManus F. Needle Stick Injury - Reducing the risk. International Orthopaedics 1996;20(3):132-3.
Rivers DL, Aday LA, Frankowski RF, Felknor S, White D, Nichols B. Predictors of nurses' acceptance of an intravenous catheter safety device. Nurs Res 2003 Jul-Aug;52(4):249-55.
Rogers B, Goodno L. Evaluation of interventions to prevent needlestick injuries in health care occupations. Am J Prev Med 2000 May;18(4 Suppl):90-8.
Russo PL, Harrington GA, & Spelman DW. Needleless intravenous systems: A review. American Journal of Infection Control 1999;27(5)431-43.
Shen C, Jagger J, Pearson RD. Risk of needle stick and sharp object injuries among medical students. American Journal of Infection Control 1999 Oct;27(5):435-7.
Skolnick R, LaRocca J, Barba D, Paicius L. Evaluation and implementation of a needleless intravenous system: Making needlesticks a needless problem. American Journal of Infection Control 1993 Feb;21(1):39-41.
Sohn S, Eagan J, & Sepkowitz, KA. Safety-Engineered Device Implementation: Does It Introduce Bias in Reporting Percutaneous Injury Reporting? Infection Control and Hospital Epidemiology 2004 Jul;25:543-7.
Sohn S, Eagan J, Sepkowitz, KA. & Zuccotti G. Effect of Implementing Safety-Engineered Devices on Percutaneous Injury Epidemiology. Infection Control and Hospital Epidemiology 2004 Jul;25:536-42.
Stebor A, Liao J. A Peripheral Catheter Indwell Study Comparing Phlebitis Rates Between Two Different Catheter Materials. Ethicon Endo-Surgery, Inc. 1995. Johnson and Johnson Published in Vascular Access.
Stringer B, Infante-Rivard C, Hanley J. Quantifying and reducing the risk of bloodborne pathogen exposure. AORN J 2001 Jun;73(6):1135-40, 1142-3, 1145-6; quiz 1147-8, 1151-4.
Suria H, Van Enk R, Gordon R, & Mattano Jr. LA. Risk of cross-patient infection with clinical use of a needleless injector device. American Journal of Infection Control 1999;27(5):444-5.
Tarantola A, Golliot F, Astagneau P, Fleury L, Brucker G, Bouvet E. Occupational blood and body fluids exposures in health care workers: four-year surveillance from the Northern France network. American Journal of Infection Control. 2003 Oct;31(6):357-63.
Whitby RM, McLaws ML. Hollow-bore needlestick injuries in a tertiary teaching hospital: epidemiology, education and engineering. Med J Aust. 2002 Oct 21;177(8):418-22.
Whitby M, Stead P, Najman JM. Needlestick injury: impact of a recapping device and an associated education program. Infect Control Hosp Epidemiology 1991 Apr;12(4):220-5.
Wolfrum, J. A Follow-up Evaluation to a Needle-Free I.V. System. Nursing Management 1994 Dec;25(12):33-5.
Yassi A, McGill ML, Khokhar JB. Efficacy and cost-effectiveness of a needless intravenous access system. American Journal of Infection Control 1995 Apr;23(2):57-64.
Younger B, Hunt EH, Robinson C, McLemore C. Impact of a Shielded Safety Syringe on Needlestick Injuries Among Healthcare Workers. Infection Control and Hospital Epidemiology 1992 Jun;13(6):349-53.
Zafar AB, Butler RC, Podgorny JM, Mennonna PA, Gaydos LA, Sandiford JA. Effect of a comprehensive program to reduce needlestick injuries. Infect Control Hosp Epidemiology 1997 Oct;18(10):712-5.
Comparison of a needleless system with conventional heparin locks
Adams KS, Zehrer CL, Thomas W.
Department of Nursing, University of Minnesota Hospital and Clinic, Minneapolis.
American Journal of Infection Control 1993 Oct;21(5):263-9
BACKGROUND: Despite the improvements in needle disposal systems, needlesticks to health care workers continue to occur at unacceptably high rates. Needleless systems have been shown to reduce the risk of needlesticks.
METHODS: This pilot study examined the safety of such a system for patients by comparing the rates of intravenous infection-related indicators between a conventional heparin lock and a needleless system. Patients (n = 97) were categorized on the basis of the duration of intravenous placement into 24-, 48-, and 72-hour groups. Within each group, half of the patients received conventional heparin locks and half received the needleless system. Intravenous infection-related indicators included catheter tip culture, adaptor fluid culture, intravenous site erythema, induration and tenderness, and elevated oral temperature.
RESULTS: Prevalence of one or more indicators was 48% for the conventional and 40% for the needleless system, a difference that was not statistically significant.
CONCLUSIONS: The needleless system appeared to pose no greater risk of infection to patients and nurses preferred it for its reduced risk of potential needlesticks.
Adams T, McCleary J, Caldero K.
Sacred Heart Medical Center, Spokane, Wash., USA.
Nephrol News Issues 2002 May;16(6):66-70, 72
Use of large-gauge, hollow-bore, arteriovenous fistula needles (AVFNs) and high-pressure accesses are unique factors inherent to the hemodialysis (HD) setting. The dialysis patient population has a higher incidence of hepatitis C (HCV) than the general population (8.4% compared to 1.8%) and the incidence of Human Immunodeficiency Virus (HIV) has increased tenfold from 1985 to 2000. HD health care workers (HCWs) are twice as likely to sustain a high-risk needlestick injury (NSI) as HCWs in all other settings. All of these factors leave HD HCWs at a high risk of exposure to bloodborne pathogens (BBPs). Although published data on NSI reduction with guarded AVFNs is lacking, many HD facilities have rushed to implement guarded AVFNs to comply with Occupational Safety and Health Administration's (OSHA) newly revised Bloodborne Pathogens Standard (29 CFR 1910.1030). For this study, we evaluated the effectiveness of one design of AVFN guard (MasterGuard Anti-Stick Needle Protector, Medisystems Corporation) by comparing its NSI rate to that of unguarded AVFNs. The unguarded AVFN injury rate was 8.58 NSIs per 100,000 unguarded AVFNs (in 81,534 cannulations) compared to zero NSIs per 100,000 guarded AVFNs (in 54,044 cannulations). The guarded AVFN showed a statistically significant NSI reduction compared to the unguarded AVFN (p < 0.029). This study demonstrates that using a guarded AVFN will help reduce HCWs' risk of exposure to BBPs in the dialysis setting.
A comprehensive approach to percutaneous injury prevention during phlebotomy: results of a multicenter study, 1993-1995
Alvarado-Ramy F, Beltrami EM, Short LJ, Srivastava PU, Henry K, Mendelson M, Gerberding JL, Delclos GL, Campbell S, Solomon R, Fahrner R, Culver DH, Bell D, Cardo DM, Chamberland ME.
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Infect Control Hosp Epidemiology 2003 Feb;24(2):97-104
OBJECTIVE: To examine a comprehensive approach for preventing percutaneous injuries associated with phlebotomy procedures.
^ : From 1993 through 1995, personnel at 10 university-affiliated hospitals enhanced surveillance and assessed underreporting of percutaneous injuries; selected, implemented, and evaluated the efficacy of phlebotomy devices with safety features (i.e., engineered sharps injury prevention devices [ESIPDs]); and assessed healthcare worker satisfaction with ESIPDs. Investigators also evaluated the preventability of a subset of percutaneous injuries and conducted an audit of sharps disposal containers to quantify activation rates for devices with safety features.
RESULTS: The three selected phlebotomy devices with safety features reduced percutaneous injury rates compared with conventional devices. Activation rates varied according to ease of use, healthcare worker preference for ESIPDs, perceived "patient adverse events," and device-specific training.
CONCLUSIONS: Device-specific features and healthcare worker training and involvement in the selection of ESIPDs affect the activation rates for ESIPDs and therefore their efficacy. The implementation of ESIPDs is a useful measure in a comprehensive program to reduce percutaneous injuries associated with phlebotomy procedures.
Prevention of needle-stick injury. Efficacy of a safeguarded intravenous cannula
Asai T, Matsumoto S, Matsumoto H, Yamamoto K, Shingu K.
Department of Anaesthesiology, Kansai Medical University, Osaka, Japan.
Anaesthesia 1999 Mar;54(3):258-61
One possible method of reducing the incidence of needle-stick injury is to use needles with safeguard mechanisms. The needle of the Insyte AutoGuard intravenous cannula can be retracted into the safety barrel. One hundred patients were randomly allocated to receive either an 18-gauge conventional Insyte intravenous cannula (group C) or the AutoGuard cannula (group AG) to assess the ease of use and efficacy of the AutoGuard device. It was possible to insert the cannula into the vein within two attempts in all patients; there was no significant difference between two groups with respect to ease of insertion. No problems, such as inadvertent withdrawal of the needle, occurred during insertion in any patient. Handling the withdrawn needle was judged significantly safer in group AG than in group C (p < 0.001). Blood contamination often occurred where a withdrawn needle was placed in group C, whereas no blood stain was detected in any case in group AG (p < 0.001). The AutoGuard cannula provides safer handling of a withdrawn needle without reducing its ease of insertion.
Differences in percutaneous injury patterns in a multi-hospital system
Babcock HM, Fraser V.
Infect Control Hosp Epidemiology 2003 Oct;24(10):731-736
OBJECTIVE: Determine differences in patterns of percutaneous injuries (PIs) in different types of hospitals.
^ : Case series of injuries occurring from 1997 to 2001.
SETTING: Large Midwestern healthcare system with a consolidated occupational health database from 9 hospitals, including rural and urban, community and teaching (1 pediatric, 1 adult) facilities, ranging from 113 to 1,400 beds.
PARTICIPANTS: Healthcare workers injured between 1997 and 2001.
RESULTS: Annual injury rates for all hospitals decreased during the study period from 21 to 16.5/100 beds (chi-square for trend = 22.7; P = .0001). Average annual injury rates were higher at larger hospitals (22.5 vs 9.5 Pis/100 beds; P = .0001). Among small hospitals, rural hospitals had higher rates than did urban hospitals (14.87 vs 8.02 Pis/100 beds; P = .0143). At small hospitals, an increased proportion of injuries occurred in the emergency department (13.7% vs 8.6%; P = .0004), operating room (32.3% vs 25.4%; P = .0002), and ICU (12.3% vs 9.4%; P = .0225), compared with large hospitals. Rural hospitals had higher injury rates in the radiology department (7.7% vs 2%; P = .0015) versus urban hospitals. Injuries at the teaching hospitals occurred more commonly on the wards (28.8% vs 24%; P = .0021) and in ICUs (11.4% vs 7.8%; P = .0006) than at community hospitals. Injuries involving butterfly needles were more common at pediatric versus adult hospitals (15.8% vs 6.5%; P = .0001). The prevalence of source patients infected with HIV and hepatitis C was higher at large hospitals.
CONCLUSIONS: Significant differences exist in injury rates and patterns among different types of hospitals. These data can be used to target intervention strategies.