Safe Injection Practices Are Not a Shot in the Dark

Too many people are being exposed to life-threatening infections because clinicians fail to follow safe practices when administering medicine by injection or infusion.

According to a recent study in Medical Care, the journal of the American Public Health Association, at least 130,000 patients were put at risk between 2001 and 2011 for pathogens including hepatitis and HIV.

As the Centers for Disease Control and Prevention (CDC) noted in response to the study, “In this age of high-tech care, it is difficult to imagine that these types of basic infection control breaches still happen.”

The study showed that exposure to dreaded viruses was the result of reusing syringes, reusing and mishandling medication vials, containers and insulin pens and narcotics theft.

Specifically, the CDC says that disease transmission occurs most commonly from:

• using the same syringe to administer medication to more than one patient, even if the needle was changed or the injection was administered through an intervening length of intravenous (IV) tubing;
• accessing a medication vial or bag with a syringe that has been used to administer medication to a patient, then reusing contents from that vial or bag for another patient;
• using medications packaged as single-dose or single-use for more than one patient (single-dose or single-use vials are labeled as such by the manufacturer);
• failing to use aseptic techniques when preparing and administering injections to prevent contamination (aseptic refers to the manner of handling, preparing and storing of medications and injection equipment such as syringes, needles and IV tubing).

Under the direction of the CDC, the Safe Injection Practices Coalition (SIPC) has compiled a multimedia toolkit for clinicians to educate themselves and their staffs. It’s part of the One & Only (“One Needle, One Syringe and Only One Time”) public health campaign to raise consciousness about injection safety.

Because many health-care providers apparently aren’t aware of how to inject patients safely (or are simply not paying attention), consumers should be assertive about safety when receiving a shot.

If you are a patient receiving an injection or infusion, make sure that the person administering it:

• does not use the same syringe for anyone else, even if the needle is changed or it’s being injected through an intervening length of IV tubing;
• does not breach a medication vial, bag or bottle with a used syringe or needle;
• does not use medications packaged as single-dose or single-use for anyone else;
• always uses aseptic techniques in preparing and administering the injection.

If you are not in the same room where the medication was prepared, if you were unable to observe that safe injection practices were employed, ask. If the answer is unclear or insufficient, refuse the medicine and request that it be newly prepared while you observe.

In 2011, a jury in Las Vegas, Nevada found two drug companies liable for damages to victims of hepatitis C infection because they knowingly sold multi-use vials of the anesthetic propofol to a clinic that used the drug in an unsanitary way. The infections could have been prevented with single-use vials. The plaintiffs were represented in that case by Rick Friedman, co-author with Patrick Malone of the “Rules of the Road” books for plaintiffs’ lawyers.