Image-directed fine-needle aspiration biopsy of the thyroid with safety-engineered devices.
OBJECTIVE
The purpose of the present study was to integrate safety-engineered devices into outpatient fine-needle aspiration (FNA) biopsy of the thyroid in an interventional radiology practice.


METHODS
The practice center is a tertiary referral center for image-directed FNA thyroid biopsies in difficult patients referred by the primary care physician, endocrinologist, or otolaryngologist. As a departmental quality of care and safety improvement program, we instituted integration of safety devices into our thyroid biopsy procedures and determined the effect on outcome (procedural pain, diagnostic biopsies, inadequate samples, complications, needlesticks to operator, and physician satisfaction) before institution of safety devices (54 patients) and after institution of safety device implementation (56 patients). Safety devices included a patient safety technology-the mechanical aspirating syringe (reciprocating procedure device), and a health care worker safety technology (antineedlestick safety needle).


RESULTS
FNA of thyroid could be readily performed with the safety devices. Safety-engineered devices resulted in a 49% reduction in procedural pain scores (P < 0.0001), a 56% reduction in significant pain (P < 0.002), a 21% increase in operator satisfaction (P < 0.0001), and a 5% increase in diagnostic specimens (P = 0.5). No needlesticks to health care workers or patient injuries occurred during the study.


CONCLUSIONS
Safety-engineered devices to improve both patient and health care worker safety can be successfully integrated into diagnostic FNA of the thyroid while maintaining outcomes and improving safety.
Montana Interventional and Diagnostic Radiology, 2969 Airport Road, Suite 1C, Helena, MT 59601, USA. THESIBB2@aol.com
Randy R
RR
Sibbitt
Dennis J
DJ
Palmer
Wilmer L
WL
Sibbitt
Arthur D
AD
Bankhurst
D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D016602:Needlestick Injuries / Q000517:prevention & control*; D011482:Protective Devices; D013594:Syringes; D013961:Thyroid Gland / Q000473:pathology*