Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-21T01:02:19.279Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of Visual versus Microscopic Methods to Detect Blood Splatter from an Intravascular Catheter with Engineered Sharps Injury Protection

Part of: BARRY FARR AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Aiysha Ansari ,
Padmaja Ramaiah ,
Lillian Collazo ,
Hamisu M. Salihu  and
Donna Haiduven
Aiysha Ansari
Affiliation:
Department of Environmental and Occupational Health, College of Public Health, University of South Florida, Tampa, Florida
Padmaja Ramaiah
Affiliation:
Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida Tampa Veterans Administration Research Center of Excellence, Tampa, Florida
Lillian Collazo
Affiliation:
Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida Microbiology Department, James A. Haley Veterans Administration Pathology and Laboratory Medical Services, Tampa, Florida
Hamisu M. Salihu
Affiliation:
Department of Environmental and Occupational Health, College of Public Health, University of South Florida, Tampa, Florida Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
Donna Haiduven*
Affiliation:
Department of Environmental and Occupational Health, College of Public Health, University of South Florida, Tampa, Florida Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida Tampa Veterans Administration Research Center of Excellence, Tampa, Florida
*
University of South Florida, College of Public Health, Department of Global Health, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, Florida 33612 (dhaiduve@health.usf.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To determine whether retractable intravenous devices produced blood splatter and whether blood splatter frequency differed between visual and microscopy detection methods.

Methods.

In this laboratory-based experiment, 105 venipunctures were performed in a simulated brachial vein containing mock venous blood. The retraction mechanism was activated in a testing chamber with precut fabric filters, placed at 3 different locations, to capture blood splatter. Differences in filter mass, visual inspection, and microscopic analysis for presence of blood on filters were the units of analysis. Descriptive statistics, paired Student t tests, and k statistics were used for data analysis.

Results.

Blood splatter was detected visually and microscopically as follows: filter A, 70% and 71%, respectively; filter B, 12% and 9%, respectively; and filter C, 13% and 10%, respectively. A statistically significant difference was observed in the mean mass of filter A between before and after activation when confirmed by the naked eye (P = .014) and microscopically (P = .0092). Substantial agreement between methods was observed for filter A (k = 0.78 [95% confidence interval, 0.64-0.92]), filter B (k = 0.73 [95% confidence interval, 0.51-0.95]), and filter C (k = 0.75 [95% confidence interval, 0.55-0.96]). However, blood was detected by microscopy and not by the naked eye in 7 instances (7%).

Conclusions.

Our findings demonstrate that splatter, which can potentially expose healthcare workers (HCWs) to bloodborne pathogens, is associated with the activation of intravascular catheters with retraction mechanisms. HCWs may not detect this splatter when it occurs and may not report a splash to mucous membranes or nonintact skin. The need to wear personal protective equipment when using such devices is reinforced.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 11 , November 2013 , pp. 1174 - 1180
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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.Haiduven, DJ, Applegarth, SP, Shroff, MP, Thompson, VP. An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices. Am J Infect Control 2009;37:127–130.Google Scholar
2.Foley, M, Leyden, AT. Needlestick safety and prevention: independent study module, http://www.who.int/occupational_health/activities/lanaism.pdf. Silver Spring, MD: American Nurses Association, 2005. Accessed October 23, 2012Google Scholar
3.Ford, JL, Phillips, P. How to evaluate sharp safety engineered devices. Nurs Times 2008;36:42–45.Google Scholar
4.Tarantola, A, Abiteboul, D, Rachline, A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control 2006;34(6):367–375.Google Scholar
5.Hibberd, PL. Patients, needles, and healthcare workers: understanding the epidemiology, pathophysiology, and transmission of the human immunodeficiency virus, hepatitis B and C, and cytomegalovirus. J Intraven Nurs 1995;18(6 Suppl):S22–S31.Google Scholar
6.Ippolito, G, Puro, V, Petrosillo, N, De Carli, G, Micheloni, G, Magliano, E. Simultaneous infection with HIV and hepatitis C virus following occupational conjunctival blood exposure. JAMA 1998;280(1):28.CrossRefGoogle ScholarPubMed
7.Hamlyn, E, Easterbrook, P. Occupational exposure to HIV and the use of post-exposure prophylaxis. Occup Med 2007;57(5): 329–336.Google Scholar
8.Panlilio, AL, Cardo, DM, Grohskopf, LA, Heneine, W, Ross, CS. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep 2005;54(RR-9):1–17.Google Scholar
9.US 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 Morb Mortal Wkly Rep 2001;50(RR-11): 1–52.Google Scholar
10.Tosini, W, Ciotti, C, Goyer, F, et al. Needlestick injury rates according to different types of safety-engineered devices: results of a French multicenter study. Infect Control Hosp Epidemiol 2010;31(4):402–407.CrossRefGoogle ScholarPubMed
11.Haiduven, DJ, McGuire-Wolfe, C, Applegarth, SP. Contribution of a winged phlebotomy device design to blood splatter. Infect Control Hosp Epidemiol 2012;33(11):1069–1076.Google Scholar
12.Asai, T, Matsumoto, S, Matsumoto, H, Yamamoto, K, Shingu, K. Prevention of needle-stick injury: efficacy of a safeguarded intravenous cannula. Anaesthesia 1999;54(3):258–261.Google Scholar
13.Asai, T, Hidaka, I, Kawashima, A, Miki, T, Inada, K, Kawachi, S. Efficacy of catheter needles with safeguard mechanisms. Anaesthesia 2002;57(6):572–577.Google Scholar
14.Ford, J, Phillips, P. An evaluation of sharp safety intravenous cannula devices. Nurs Stand 2011;26(15-17):42–49.CrossRefGoogle ScholarPubMed
15.Ravai, AP, Baker, JD, Ponton, MK. Correlation and prediction tests. In: Social Sciences Research Design and Statistics. Chesapeake, VA: Watertree, 2013:378–381.Google Scholar
16.University of North Carolina Department of Epidemiology. Bloodborne pathogens: an occupational hazard for healthcare workers, http://www.unc.edu/rlensley/bbp.htm. 2010. Accessed May 19, 2013.Google Scholar
17.Haiduven, DJ, Applegarth, SP, DiSalvo, H, Mangipudy, S, Konopack, J, Fisher, J. A pilot study to measure the compressive and tensile forces required to use retractable intramuscular syringes. Am J Infect Control 2006;34(10):661–668.Google Scholar
18.Haiduven, DJ, Applegarth, SP, McGuire-Wolfe, C, Tenouri, M. Automated and manual measurement of the forces required to use retractable intramuscular syringes. J Musculoskelet Res 2010;13(2):65–74.Google Scholar
19.Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens: needlestick and other sharps injuries; final rule. http://www.osha.gov/SLTC/bloodbornepathogens/standards.html. 2001. Accessed October 23, 2012.Google Scholar