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Show full transcript for Safe Injection Practices video

A basic expectation that exists in any healthcare setting is the protection from an infection (blood and other potentially infectious materials) while receiving an injection. In this lesson, we'll cover some ways in which you can better help protect the patient, as well as yourself.

Safer Devices Equals a Safer Environment

For employers, the Needlestick and Prevention Act requires that they provide appropriate, effective, safe, and commercially available medical devices that are designed to eliminate or minimize your occupational exposure if ever unsafe injection practices occur.

However, combining those safer devices with a better awareness of the potential risks, along with aseptic infection control techniques, should ultimately be your goal, as thousands of infections occur each year in the U.S. as a result of unsafe injection practices.

Warning: The most common unsafe injection practices include re-using needles, using multiple-dose medications or bags of solutions, and administering the same intravenous medications to multiple patients.

Safe injection practices are instrumental to following the standard precautions and include safe sharps disposal practices – such as using leak-proof, puncture-resistant appropriate sharps containers – along with using sharps and needle devices that have been engineered with injection protections. This includes any time you withdraw blood or other bodily fluids, access a patient's vein or artery, or administer medications and other fluids.

An example of a device with injection protection would be an angiocatheter with a button on the side that allows you to easily withdraw the needle once inserted into the catheter, while the catheter remains in the patient's vein. The needle now has a protective covering so there is no risk of getting poked and can safely be disposed in a sharps container.

Pro Tip #1: Don't bend, break, or recap needles. However, if you must recap a needle, do so using the one-hand method shown in the video for this lesson. A recapping situation would include withdrawing medication from a multi-dose vial. Rather than leave on a tray or table with the needle exposed, you can use the one-hand method to reinsert the needle into its protective sheath while waiting to administer the medication to the patient.

Aseptic Techniques Equals a Safer Environment

Make sure to always use aseptic techniques to avoid the contamination of sterile injection equipment. This includes washing your hands, using clean gloves, and using alcohol wipes to clean injection portals, the tops of vials, and the skin where needles will be inserted.

Remember to always change your gloves between patients and between tasks that may increase the chances of infection. And it's a good idea to have a generous supply of gloves so you don't run out.

Pro Tip #2: Never administer medication from a single syringe to multiple patients, even if the needle has been replaced. Needles and syringes are sterile, single-use items. You can remember this rule with this little ditty: 1 needle, 1 syringe, 1 time only!

Other single-use pieces of equipment are fluid infusion and administration sets (IVs, IV bags, tubing, connectors, etc.) and syringe and needle cannulas. One use, one time, then dispose of these items safely. And remember, if any sterile item touches a non-sterile item, throw it away and get another.

When preparing an injection, keep work areas free of clutter and wash your hands appropriately. Gloves are not usually required when giving an injection, but there are some exceptions:

  • If excessive bleeding is expected
  • If other bloodborne pathogen risks exist
  • If you have dry, cracked skin or cuts, abrasions, etc.

If using a glass ampule, don't use your bare fingers to open it. Instead, use a gauze pad to break the seal and use a filtered needle when drawing from any glass ampule. Then change to a non-filtered needle before administering the medication to the patient.

Also, make sure to check the name, dosage, and proper delivery method before administering any medications. And never re-enter the same vial with the same needle and syringe; always use a new needle and syringe.

Single-Dose vs. Multi-Dose Vials

Use single-dose vials whenever possible to reduce the chances of infection, especially when the same medication is being administered to multiple patients. And do not combine the contents of one vial to another.

If you are using multi-dose vials, make sure both the syringe and the needle are sterile. If there is any doubt, toss them out. Store all medication vials according to the manufacturers' recommendations and don't keep multi-dose vials in patient treatment areas.

Also, don't use bags or bottles of IV solutions as a common source of supply for multiple patients.

Pro Tip #3: Whenever performing spinal lumbar puncture procedures, be sure to wear a surgical mask when placing the catheter or injection material into the spinal canal or the subdural space.

OSHA's Requirements

OSHA requires that any exposure control plan reflect how employers implement new developments in control technology.

OSHA requires employers to solicit input from employees who are responsible for direct patient care, and this includes the identification, evaluation, and selection of better engineering and work practice controls.

OSHA also requires that certain employers establish and maintain a sharps injury log of all percutaneous injuries from contaminated sharps. The sharps injury log must include the location of the incident, the device involved, and a description of the incident (at minimum) to properly evaluate future risks and device effectiveness.

Employers are required to record all work-related sharps injuries involving contaminated objects on both the OSHA 300 log and the OSHA 301 log.

Warning: If you're ever stuck by a needle or other sharp, or get blood or OPIM in your eyes, nose, mouth, or by contact with broken skin, immediately flood the exposed area with water. Clean any wound or broken with soap and water or a skin disinfectant if available. Report the incident to your employer and get immediate medical attention.