Enhance Safety Program: Introduce Pre-heparinized syringe with safety device to Medical Interns in Prince of Wales Hospital

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Authors (including presenting author) :
LO CSL (1), HO VSC (2), LI PKT (1)(2)
Affiliation :
(1) Occupational Medicine Care Service, NTEC (2) Occuaptional Safety & Health, PWH
Introduction :
Sharps injuries expose healthcare workers to blood-borne pathogens and continue to be a serious health and safety hazard. Taking an arterial blood gas (ABG) involves using a needle and syringe to directly sample blood from an artery, it is necessary to take the cap off the needle, flush the heparin through the syringe and recap the needle cap then again locate the artery using your non-dominant hand and such procedure will increase the risk of needle stick injury (NSI) during the blood taking process. From 2015 to 2016, the number of NSI regarding ABG procedure increased by more than 100 % in Prince of Wales Hospital (PWH). Nearly 50 % of injury related to recapping of needle either after preparing heparin or finished blood taking step. Therefore, preset heparinized syringe with safety device (safety engineered blood gas syringe) was introduced in June 2017 to three medical wards in PWH for trial use.
Objectives :
1. Prevent NSI by minimizing needle recapping. 2. Explore the advantage on using preset heparinized syringe with safety device.
Methodology :
1. Preset heparinized syringes with safety device were provided to three medical wards for trial use from June to December 2017. 2. Two identical one-hour simulation workshops were organized during the Medical Intern Orientation Programme held in April and June 2017. The training contents mainly focused on the use of safety engineered blood gas syringes for those medical interns who were working in the medical wards . 3. Questionnaires were issued to those medical interns who have attended the simulation workshops during the trial period of preset heparinized syringe with safety device to collect their feedback from September to December 2017.
Result & Outcome :
No (0%) NSI regarding ABG extractions occurred in the three trial medical wards by using pre-heparinized syringe with safety shield since implementation. A total of 48 questionnaires were issued with 38 returned and the response rate was 79%. 26 (68%) medical interns have tried the safety device. Around 60% of them used safety device ranging from 10 times to more than 30 times within a month. A total of 85% medical interns found the safety device was useful for taking ABG and could enhance their occupational safety. Also, more than 70 % of them commended the device was user friendly and able to minimize the steps for preparing heparin. More than 50% of them believed this safety device was more reliable for taking ABG and felt more safety and confidence. Conclusion Safety-engineered blood gas syringes and injectors may be advantageous to optimize patient comfort during blood taking as well as protect the physician from sustained secondary injuries and contracted infectious diseases in places such as medical wards where infectious status of patients may be unknown. The use of safer products is known to reduce the risk of needle-stick injuries for healthcare professionals.

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