title: Evaluation of a safety resheathable winged steel needle for prevention of percutaneous injuries associated with intravascular-access procedures among healthcare workers.
abstract: OBJECTIVE
  To compare the percutaneous injury rate associated with a standard versus a safety resheathable winged steel (butterfly) needle.
  
  
  METHODS
  Before-after trial of winged steel needle injuries during a 33-month period (19-month baseline, 3-month training, and 11-month study intervention), followed by a 31-month poststudy period.
  
  
  METHODS
  A 1,190-bed acute care referral hospital with inpatient and outpatient services in New York City.
  
  
  METHODS
  All healthcare workers performing intravascular-access procedures with winged steel needles.
  
  
  METHODS
  Safety resheathable winged steel needle.
  
  
  RESULTS
  The injury rate associated with winged steel needles declined from 13.41 to 6.41 per 100,000 (relative risk [RR], 0.48; 95% confidence interval [CI95], 0.31 to 0.73) following implementation of the safety device. Injuries occurring during or after disposal were reduced most substantially (RR, 0.15; CI95, 0.06 to 0.43). Safety winged steel needle injuries occurred most often before activation of the safety mechanism was appropriate (39%); 32% were due to the user choosing not to activate the device, 21% occurred during activation, and 4% were due to improper activation. Preference for the safety winged steel needle over the standard device was 63%. The safety feature was activated in 83% of the samples examined during audits of disposal containers. Following completion of the study, the safety winged steel needle injury rate (7.29 per 100,000) did not differ significantly from the winged steel needle injury rate during the study period.
  
  
  CONCLUSIONS
  Implementation of a safety resheathable winged steel needle substantially reduced injuries among healthcare workers performing vascular-access procedures. The residual risk of injury associated with this device can be reduced further with increased compliance with proper activation procedures.
authors.affiliation: Department of Medicine and Infection Control, Mount Sinai School of Medicine, Mount Sinai Medical Center, New York, New York 10029, USA.
authors.forename: Meryl H
authors.initials: MH
authors.lastname: Mendelson
authors.forename: Bao Ying
authors.initials: BY
authors.lastname: Lin-Chen
authors.forename: Robin
authors.initials: R
authors.lastname: Solomon
authors.forename: Eileen
authors.initials: E
authors.lastname: Bailey
authors.forename: Gene
authors.initials: G
authors.lastname: Kogan
authors.forename: James
authors.initials: J
authors.lastname: Goldbold
mesh_terms: D017848:Blood-Borne Pathogens; D002408:Catheters, Indwelling / Q000592:standards*; D004869:Equipment Safety; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D017744:Medical Waste Disposal; D009339:Needles / Q000592:standards*; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control*; D009519:New York City / Q000453:epidemiology; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D011482:Protective Devices / Q000592:standards*
chemical_list: D017744:Medical Waste Disposal