title: The use of metal or plastic needles in continuous subcutaneous infusion in a hospice setting.
abstract: OBJECTIVE
  Battery-driven portable syringe drivers are a convenient method for administering many drugs by continuous subcutaneous infusion (CSCI) to patients who cannot swallow medications. At the St. Clare Hospice, nurses usually use plastic needles to minimize needlestick injury but sometimes have patients transferred to metal needles. This study retrospectively examines this practice and its effectiveness.
  
  
  METHODS
  The duration of audit was four months. During this period, there were 40 patients (23 women, 17 men), who required their medications delivered by CSCI. A total number of 74 sites were used. Metal or plastic needle CSCIs connected with one-hour release Graseby Syringe Drivers were used. The syringes were set to deliver 2 mm/hour. The maximum volume syringe used was 50 ml. The data were collected retrospectively. Analysis and results. Sixteen patients (21.6 percent) developed minor complications (13 plastic, three metal). Among them, 16 showed inflammation. Two patients (3.5 percent) showed slight bleeding. Only one patient (1.7 percent) showed local infection (metal). In 14 patients (18.9 percent), the needle was reinserted due to various reasons, including needles pulled out by patients or needles falling out due to unknown reasons. There were no needlestick injuries reported, and the staff members reported that all problems encountered were easy to identify and resolve.
  
  
  CONCLUSIONS
  Plastic needle CSCI prevents needlestick injury and gives minimum distress to the patients. More research is needed to determine the local side effects of drugs used and the strategies to resolve these problems.
authors.affiliation: St. Clare Hospice, Hastingwood, Essex, United Kingdom.
authors.forename: Syed Qamar
authors.initials: SQ
authors.lastname: Abbas
authors.forename: Margaret
authors.initials: M
authors.lastname: Yeldham
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004209:Disposable Equipment / Q000592:standards; D004869:Equipment Safety; D005260:Female; D017051:Hospice Care / Q000379:methods / Q000592:standards*; D006801:Humans; D007279:Injections, Subcutaneous / Q000295:instrumentation; D008297:Male; D008485:Medical Audit; D008670:Metals; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects / Q000592:standards*; D016602:Needlestick Injuries / Q000517:prevention & control; D010969:Plastics; D012189:Retrospective Studies; D013594:Syringes / Q000009:adverse effects / Q000592:standards*; D006113:United Kingdom
chemical_list: D008670:Metals; D010969:Plastics