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December, 2007


Copyright 2007 Center for Phlebotomy Education, Inc.
 All rights reserved. View our copyright policy.

 

Safety Devices Reduce Needlestick Rate 93%

A recent study published in the journal Infection Control and Hospital Epidemiology showed that implementation of safety needles facility-wide can reduce accidental needlestick rate up to 93%. A facility in Alicante, Spain implemented engineered devices to prevent percutaneous injury in the emergency department and half of the hospital wards. Procedures specifically targeted included IV insertion, phlebotomy, arterial sampling, fingersticks, and injections. The nurses involved were provided with 3 hours of training in bloodborne exposures, and 2 hours of hands-on training. During the course of the study, wards not using safety devices reported 14 accidental needlesticks compared to one for those that were.

Specifically, rates in the emergency department decreased from 18.3 injuries per 100,000 patients before implementation to none after safety sharps were adopted. In wards using devices engineered for safety versus those that weren't, the rate was 5.2 injuries per 100,000 patient days versus 44.0. In the control wards where the intervention was not implemented, rates remained steady.

The study calculated the cost of implementation of safer sharps, and found an increase in the direct costs to be 75-86 cents per patient day.

Click here for a complete (PubMed) abstract.

CLSI Revises Venipuncture Standard

Late last month, the Clinical and Laboratory Standards Institute (CLSI) released its newly revised venipuncture standard, Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture, (H3-A6). Since 1979, the document known throughout the industry as "H3" has been standardizing the procedure for venipunctures around the world, and defining the industry's standard of care. Significant changes include new full-color illustrations of the anatomy of the antecubital area, revised passages on drawing blood during the IV infusions, collecting blood cultures, steps to take if the patient feels an electric, shooting-pain sensation, more detailed language on the effects of hemoconcentration, and a critical new step required when labeling specimens. The revision was chaired by Dennis J. Ernst MT(ASCP), the director of the Center for Phlebotomy Education, and took nearly a year to complete.

By special arrangement with CLSI, the Center for Phlebotomy Education is providing a free printed copy of the revised venipuncture standard with every purchase of the complete Applied Phlebotomy video series. (See this month's "Featured Product" below.)

[Editor's note: a more detailed article of the specific changes to the standard is included in this month's issue of Phlebotomy Today. For single-issue purchase and subscription information, visit www.phlebotomy.com/PhlebotomyToday.html.]

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This Month in Phlebotomy Today

Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter (currently in its 8th year of publication), are reading about this month:

  • Feature Article: CLSI Revises Venipuncture Standard
  • Ask the Safety Lady: OSHA consultant addresses these burning questions:
    • Our phlebotomy team likes to decorate the area for the holidays. Are there any safety precautions we should take?
    • How should we dispose of the waste we generate in the phlebotomy area?
  • Phlebotomy in the News: a synopsis of articles on phlebotomy and phlebotomists who made Internet headlines in November including these stories:
    • Decentralized Phlebotomy Falls from Favor
  • According to the Standards: Is a tourniquet always necessary?
  • Tip of the Month: A Run for the Roses
  • On a Personal Note: They do things differently in Europe. (Now accessible from our home page!)
  • CEU questions (institutional version only).

Buy this issue for only $9.95.

For subscription rates and to subscribe to Phlebotomy Today, visit www.phlebotomy.com/PhlebotomyToday.html. The current month’s issue will be emailed to you immediately upon subscribing.

Center Expands into New Offices

Last month, the Center for Phlebotomy Education (publisher of the Phlebotomy Today family of newsletters including PT-STAT!) completed its long-awaited relocation. "We realized we had outgrown our original office over a year ago," said Dennis J. Ernst, MT(ASCP), the Center's director, "and resolved to seek larger accomodations during the 2007 calendar year." According to Ernst, the relocation team reviewed many properties in Southern Indiana and finally selected a new office building in Corydon.
     "The property seemed to be meant just for us and our growing company," says Ernst. "Corydon is a quaint community, and is still a convenient commute for our staff. More importantly, the new location enhances our infrastructure in ways that will substantially increase our ability to meet the needs of our customers and the global phlebotomy community."

     The Center's mailing address remains the same, at least for the short term, as does its toll free phone number (866-657-9857). However, its fax number has changed. The new number is 812-738-5750.
      The Center develops educational material for healthcare professionals who perform, teach or supervise blood specimen collection procedures with a growing catalog of over 40 products including videos, online resources, books, posters, and continuing education materials.

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Featured FAQ: Transporting blood in a syringe

Question: I see phlebotomists and other blood collection personnel collect blood meant for blood cultures in a syringe and then carry it all the way to the (microbiology) lab where they then dispense it into the appropriate blood culture media. This could be because they did not have the media at the point of collection. Considering specimen sterility, the prolonged time the specimen remains in the syringe, and the safety of the collector, is this appropriate?

Response: This practice probably won't compromise the results if the only test being performed is the blood culture. Bacteria will grow whether the blood is clotted or not. However, it may be a safety issue for two reasons. First, if the collector is carrying the device with the needle exposed, the risk is obvious. (I'm assuming they know better, and are activating the safety feature on the needle immediately upon collection.) The second risk is that, by the time the collector arrives to the micro department, the blood is clotted in the barrel or the hub of the syringe. If so, the collector might be tempted to push on the plunger to force the blood into the culture bottle. Even if the collector replaced the needle with a safety transfer device as is required, the safety transfer device can explode off of the syringe and blood could splatter the face and garments.

A facility that nurtures a culture of safety does not allow blood to be transported in a syringe (unless it is a blood gas, of course), and insists all blood be evacuated into the appropriate tubes or bottles at the patient's side.

Each month, PT--STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's web site. For information on joining Phlebotomy Central, visit www.phlebotomy.com/PhlebotomyCentral.html.

Specimen Collection Safety: Tearing fingertips off of gloves

Do you ever tear off the tip of your glove to help you find a vein? If this is in your bag of tricks, you might as well not even put the gloves on in the first place. Compromising the integrity of any personal protective device puts you at risk. To make the location of the vein easier after donning gloves, take note of certain landmarks on the skin when you initially find the vein (i.e., freckles, skin creases, hairlines, skin contours, etc.). Once mapped in this manner, you are more likely to relocate it prior to needle insertion without having to compromise your safety when your gloves are on. Use these techniques and you won’t need to employ this common but dangerous practice.

Remember, gloves are required by OSHA whenever performing vascular access procedures. Since gloves by definition have fingers, removing them is not an option.


Featured Product: Free CLSI Venipuncture Standard

By special arrangement with CLSI, the Center for Phlebotomy Education is making printed and bound copies of the newly revised CLSI venipuncture standard, document H3-A6, available for free with every purchase of the complete Applied Phlebotomy video series. If purchased separately from either CLSI or the Center, the standard would otherwise cost $200. [Editor's note: facilities that are CLSI members can purchase the standard at a discounted member rate from CLSI.] The standard is also available separately from the Center as an immediate download or in soft cover.

The Applied Phlebotomy video series includes three videos: "Basic Venipuncture," "Preventing Preanalytical Errors," and "Avoiding Phlebotomy-Related Lawsuits," and are the only specimen collection videos on the market that are current with all CLSI standards and OSHA guidelines. The Center is offering the standard free with the video purchase through the month of December. To purchase the video set and receive the standard for free, click here or type www.phlebotomy.com/Videos.html into your browser.

H3A6

By special arrangement with CLSI, printed or electronic versions of the CLSI venipuncture standard (H3-A6) are now available at www.phlebotomy.com.

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If this issue was forwarded to you from a friend, subscribe here to receive your own copy each month so that you never miss a single issue of the only free monthly newsletter on the planet devoted exclusively to blood specimen collection!

Newsletter Information:

PT STAT! is a free, monthly educational service provided by the Center for Phlebotomy Education, Inc., the most respected authority in phlebotomy. For a complete company profile and product list for all healthcare professionals who perform, teach or manage specimen collection procedures, visit us on the Internet at: http://www.phlebotomy.com.
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Copyright 2007, Center for Phlebotomy Education, Inc. All rights reserved. Newsletters may contain links to sites on the Internet owned and operated by third parties. The Center for Phlebotomy Education, Inc. is not responsible for the availability of, or the content located on or through, any such third-party site. Information in this document is provided "as is," without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose and freedom from infringement. The user assumes the entire risk as to the accuracy and the use of this document. We will not be liable for any damages of any kind arising from the use of this information, including, but not limited to direct, indirect, incidental, punitive, and consequential damages.