[MCOH-EH] Safety devices for shorter insulin needles?

Swift, Melanie melanie.swift at Vanderbilt.Edu
Thu May 5 14:11:29 PDT 2016
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Got it. That is really helpful info!
Thank you Amber

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Dr Amber H Mitchell
Sent: Thursday, May 05, 2016 1:41 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?

No.  Q 11 is when during the clinical use of the device did the injury occur.  In this case, 41.4% occurred in situations like you describe - when the person is actually giving the injection and patient moves or they are pinching skin and injure their other hand.

The next set of percentages is different.  It asks, if you were using a safety device (in this case, I pulled ONLY injuries with a safety syringe) did you have an injury with that safety feature before, during, or after activating the safety feature.  In this case, 41.4% (a pure coincidence to same percentage above) occurred while actually activating the safety feature after the injection was given and done.



On 5/5/16, 2:05 PM, "Swift, Melanie" <melanie.swift at Vanderbilt.Edu> wrote:

>Amber, to clarify, in this database, is all "during use" activation of 
>the safety? We use "during use" when the person is actually giving the 
>injection and sticks themselves because the patient moved, for instance.
>We track "while activating safety device" separately and find it's a 
>much lower number.
>
>Melanie Swift, MD
>Director, Vanderbilt Occupational Health Clinic 
>http://occupationalhealth.vanderbilt.edu
>
>
>-----Original Message-----
>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Dr Amber 
>H Mitchell
>Sent: Thursday, May 05, 2016 12:50 PM
>To: MCOH/EH
>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>
>If it helps the group, we did some advanced data extraction from our 
>EPINet aggregate of hospitals (2010-2014).
>
>This data is from sharps injuries that were reported to employee health 
>from ONLY safety devices used ONLY during injection and ONLY among nurses.
> I have blood collection device data too, if anyone feels it would be 
>useful send me an email.
>
>11. Did the injury occur?
>
>	1 Before use of item							4				0.7%
>	2 During use of item							232				41.4%
>	3 Between steps of a multi-step procedure			13				2.3%
>	4 Disassembling device or equipment				15				2.7%
>	5 In preparation for reuse of reusable instruments	1				0.2%
>	6 While recapping a used needle					31				5.5%
>	7 Withdrawing a needle from rubber or other resistance	4			0.7%
>	8 Other after use, before disposal					159				28.4%
>	10 While putting the item into the disposal container	21			3.8%
>	11 After disposal, stuck by item protruding from disposal
>container		4		0.7%
>	13 After disposal, item protruding from trash bag or inapp
>container		2		0.4%
>	14 Other, describe								66				11.8%
>	15 Restraining patient							1				0.2%
>	16 Device left on floor, table, bed or other inappropriate place	7	1.3%
>Total records:	560
>
>
>
>And this is when they are occurring during the use of safety syringes.
>Q13b.
>1  Before activation			241			48.0%
>	2  During activation			208			41.4%
>	3  After activation				52			10.4%
>	4  Unknown					1			0.2%
>
>
>
>You¹ll note that more than 40% of injuries occur during activation of 
>the safety feature.  Again, this is skin injection only and the use of 
>safety devices only.
>
>
>Amber
>
>Amber Hogan Mitchell, DrPH, MPH, CPH
>President | Executive Director
>International Safety Center
>Email: amber.mitchell at internationalsafetycenter.org
>
>
>
>
>On 5/5/16, 11:14 AM, "Sampson, Deborah" <Deborah.Sampson at snhhs.org> wrote:
>
>>Haven't seen that. What I am identifying is that most sticks in the 
>>last
>>6 months were due to inattention during clean up, during disposal or 
>>safety activation such as speaking with the patient, family, or a 
>>colleague.
>>We are considering suggesting a " Watch that needle" campaign.
>>Deb
>>Deborah A. Sampson, PhD, APRN, COHN-S, FAANP Director Employee Health 
>>and Wellness Services
>>Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street
>>Nashua, NH 03060
>>p(603) 281-8583  f (603) 577-5665
>>deborah.sampson at snhhealth.org
>>
>>
>>
>>
>>
>>-----Original Message-----
>>From: MCOH-EH
>>[mailto:mcoh-eh-bounces+deborah.sampson=snhhs.org at mylist.net] On 
>>Behalf Of Hudson, T. Warner
>>Sent: Thursday, May 05, 2016 11:00 AM
>>To: MCOH/EH
>>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Melanie - I know when we replaced all 350,000 per year re-sheathing 
>>butterflies here in 2012 with the BD retractable butterfly ,ones we 
>>heard about the peds insulin needle issue and have not had a solution 
>>so very interested in how this plays out.
>>
>>An on another note we are seeing 2-5 incidents where people report the 
>>needle in the BD retractable butterfly needle did not retract.  We 
>>spoke with BD a couple years ago and they were skeptical, said they 
>>checked with their quality folks, and et we keep getting reports of 
>>this; it think 4 last year. It is possible to touch so lightly the 
>>needle does not retract before removing from the vein but to me this 
>>is a training issue as there is an audible click when the little 
>>triangle is pressed correctly.  But I want to be open to the 
>>possibility of a manufacturing problem too.  Is anyone else seeing 
>>these reports of non - retraction?
>>
>>Thanks,
>>
>>Warner
>>
>>T. Warner Hudson, MD FACOEM, FAAFP
>>Medical Director, Occupational and Employee Health UCLA Health System 
>>and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID
>>27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org
>>
>>
>>-----Original Message-----
>>From: MCOH-EH
>>[mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf 
>>Of Sampson, Deborah
>>Sent: Thursday, May 05, 2016 4:44 AM
>>To: MCOH/EH
>>Subject: Re: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Haven't dealt with this peds population issue yet.
>>What I do know is that our patient care staff developed a way to use a 
>>table top to engage the caps on BD syringes because we were getting 
>>needle sticks when staff tried closing the safety cap.
>>
>>Now the only time we get sticks from engaging the cap is when staff do 
>>not use the table top technique.
>>
>>
>>
>>-----Original Message-----
>>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, 
>>Melanie
>>Sent: Wednesday, May 04, 2016 9:29 PM
>>To: MCOH/EH
>>Subject: [MCOH-EH] Safety devices for shorter insulin needles?
>>
>>Need your collective wisdom, MCOH peeps!
>>
>>Our pediatric diabetes team is looking for an insulin syringe with a 
>>6mm needle. They believe that  pediatric Type I DM pts are at risk for 
>>getting their insulin IM with the standard 1/2 inch needle, and they 
>>send patients home with a 6mm needle (which is a nonsafety needle for 
>>home
>>use.)
>>
>>Problem: the only safety device we've found in this length is a BD 
>>safety glide product that is basically a little hard cap on a sliding 
>>stick. It does not cover the entire needle, just bobbles out there 
>>like a tiny hard hat on the tip of the needle. I tried to activate and 
>>slid the thing out but it didn't catch - it slid back onto the needle, 
>>bending it sideways, then when I did get it to lock I had a completely 
>>exposed tip sticking out sideways.
>>
>>Anyone use this product and have experience with how it performs in 
>>terms of injury?
>>Anyone know of another short safety-engineered insulin needle?
>>Has anyone dealt with this pediatric issue of making sure the SQ 
>>injection isn't too deep?
>>
>>Thanks!!
>>Melanie Swift, MD
>>Medical Director, Vanderbilt Occupational Health Clinic 
>>occupationalhealth.vanderbilt.edu
>>
>>Excuse any typos please - Sent from my iPad.
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>
>
>---------------------------------------
>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>List membership is free, but only subscribers may post to the list.
>To post send messages to: mcoh-eh at mylist.net To become a subscriber, or 
>to change your subscription options (turn off
>email while you're on vacation, etc):   http://www.mcoh-eh.net
>MediTrax / Occupational Health Systems, Inc. provides financial support 
>to ensure the list remains a free resource for the occupational health 
>community.
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>List archives (public): http://mylist.net/archives/mcoh-eh/
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>Send administrative requests to: drjoe at meditrax.com
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>---------------------------------------
>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>List membership is free, but only subscribers may post to the list.
>To post send messages to: mcoh-eh at mylist.net To become a subscriber, or 
>to change your subscription options (turn off
>email while you're on vacation, etc):   http://www.mcoh-eh.net
>MediTrax / Occupational Health Systems, Inc. provides financial support 
>to ensure the list remains a free resource for the occupational health 
>community.
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The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
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List archives (public): http://mylist.net/archives/mcoh-eh/
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Send administrative requests to: drjoe at meditrax.com
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