APIC takes strong position on ensuring safe injection practices

By: David LaHoda August 11th, 2009

In response to continuing reports of patient-to-patient transmission of bloodborne viruses during routine procedures, especially in outpatient settings, the Association for Professionals in Infection Control and Epidemiology (APIC) published a position paper promoting safe injection, infusion and medication vial practices on July 30.

There have been more than 35 outbreaks in the U.S. during the last 10 years that have “resulted in the transmission of either hepatitis B or C to more than 500 patients,” according to APIC. The unsafe practices by healthcare workers that caused these “devastating effects,” APIC says, are:

Syringe reuse between patients during parenteral medication administration to multiple patients
Contamination of medication vials or intravenous (IV) bags by accessing them with a used syringe and/or needle
Failure to follow basic injection safety practices when preparing and administering parenteral medications to multiple patients
Inappropriate use of fingerstick devices and glucometer equipment between patients

The position paper then identifies and strongly encourages healthcare facilities to practice and monitor for 48 practices dealing with these areas (See Safe Injection, Infusion and Medication Vial Practices in Healthcare, pages 2-5):

Aseptic technique (five practices)
IV solutions (six practices)
Flushing (two practices)
Syringes (six practices)
Vials (15 practices)
Blood glucose monitoring devices (seven practices)
Protection and training of healthcare workers (seven practices)

Concerning the training of healthcare workers, the APIC recommendations call for: ensuring that staff preparing or administering injections or other parenteral medications are competent to aseptically perform the safe work practices identified, and that facilities periodically assess compliance by observing and evaluating personnel performing these procedures.

For more information on training staff members in injection safety, see the bloodborne pathogens chapters of the Quality America OSHA Safety Program manuals for medical and dental practices.

A previous post on “One and Only” events provides links to downloadable posters instructing staff members on safe injection practices.

Also, check the Tools section of this blog for FAQ on Safety Injection Practices and a Checklist for Infection Control and Safe Injection Practices to Prevent Patient-to-Patient Transmission of Bloodborne Pathogens.

Finally the he CDC offers quite a few resources for injection safety.

The Infection Prevention Core Training Bundle is a comprehensive three-part Webcast series that focuses specifically on IC best practices. With expert advice from OSHA Healthcare Advisor bloggers and IC experts Peg Luebbert and Libby Chinnes, this bundle is your complete solution for staff education on infection prevention, and a solid training foundation for your IC program.

Comments(2) Featured, Infection Control

Comments

By Jeanette Lindberg on August 13th, 2009 at 3:50 pm

Subject: APIC Position Paper: Safe injection, infusion and Medication vial practices in Healthcare
Question: Page 2, IV Solutions States that a bag of IV fluid must be used within 1 hour after being spiked. Is this the newest standard? Can you e-mail some references that would confirm this? Thank you.

By David LaHoda on August 13th, 2009 at 4:00 pm

The date on the APIC position paper is July 30, 2009. If you have a question about the paper, contact APIC using the information in the letterhead.