title: [Safety-engineered devices to prevent percutaneous injuries: cost-effectiveness analysis on prevention of high-risk exposure].
abstract: OBJECTIVE
  To assess the efficiency of the replacement of several medical devices by engineered sharp injury (SI) prevention devices (ESIPDs).
  
  
  METHODS
  The cost-effectiveness ratios of the replacement of medical devices in use by ESIPDs were estimated: their purchasing costs and the direct costs of sharp injury care were taken into account; the number of SI avoidable by each ESIPD was estimated from the 252 occupational SI notified by healthcare workers at a 1,300 bed hospital from March 2002 to February 2003. The relationship between ESIPD additional costs and the number of high-risk SI was estimated (SI were classified as high-risk if they met two or more of the following criteria: moderately-deep or deep injury, injury with a device previously inserted in an artery or vein, or with a device exposed to blood).
  
  
  RESULTS
  ESIPDs order according to cost-effectiveness ratio: safety needle for implanted ports (-2.65 euro/SI avoided), followed by syringes with protective shield (869.79 euro/SI), resheathable winged steel needles, needleless administration sets, and short catheters with protective encasement. ESIPDs order according to relationship between additional costs and number of high-risk sharp injuries avoided: safety needles for implanted ports, followed by winged steel needles, hypodermic syringes, short catheter and needleless administration sets.
  
  
  CONCLUSIONS
  Savings in SI care outweigh additional costs of certain ESIPDs. Cost-effectiveness analysis is useful in assigning priorities; however the risks of SI by every device must be taken into account.
authors.affiliation: Servei de Medicina Preventiva, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. larmadan@vhebron.net
authors.forename: Lluís
authors.initials: L
authors.lastname: Armadans Gil
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Fernández Cano
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Albero Andrés
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Anglés Mellado
authors.forename: José María
authors.initials: JM
authors.lastname: Sánchez García
authors.forename: Magda
authors.initials: M
authors.lastname: Campins Martí
authors.forename: Josep
authors.initials: J
authors.lastname: Vaqué Rafart
mesh_terms: D000062:Accidents, Occupational / Q000191:economics* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D006801:Humans; D016602:Needlestick Injuries / Q000191:economics* / Q000517:prevention & control*; D016273:Occupational Exposure / Q000191:economics* / Q000517:prevention & control*; D011482:Protective Devices / Q000191:economics*; D012307:Risk Factors