Re: Sharps Safety and Recapping Drawing up Needles

10/10/2019 at 9:06 am #75890

Michael Wishart

Participant

Author:
Michael Wishart

Email:
Michael.Wishart@svha.org.au

Organisation:

State:
NSW

Hi Sam

In my understanding no manipulation of sharps is recommended because of the risks of either sharps injury or damage to the sharp resulting in harm to the patient (eg needle breaking off inside patient). Even manipulating clean needles may result in an exposure if the manipulation is done using gloves contaminated with blood or body fluid.

Where needles are required to have angled tips, there should be specifically manufactured needles used for this, rather than manipulation of the needles.

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au

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From: ACIPC Infexion Connexion On Behalf Of Sam Dickson
Sent: Wednesday, 9 October 2019 8:17 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up Needles

Hi Brains Trust,
what are your thoughts on ‘bending’ CLEAN needles for anaesthetic or ophthalmic procedures? I’m currently reviewing our ‘Sharps Handling Procedure’ and it was suggested that ‘bending’ should be added to the procedure. In my research ‘bending’ is not supported by any standard/guideline. Your thoughts appreciated….

Kind regards
Sam Dickson
E+E Hospital
Victoria

On Mon, 7 Oct 2019 at 12:24, Lesley Lewis <Lesley.Lewis@nhw.org.au> wrote:
Dear all,
Safety devices for recapping needles have been on the market for many years.
Recapping needles by hand is a risky practice (and habit) that should not be encouraged for any needles clean or used (a one size fits all approach)

Fiona raises a good question and I too am interested to hear if there is any literature and evidence validating the risk of chemical exposure (medications/drugs) to clinical staff through aerosol and splash when priming syringes and other equipment.
How can the risk be managed?
Is recapping the only possible risk management method?
Are there any alternative methods?
If the risk is serious should fume cabinets have a place in ward medication rooms?

As noted in the original post a needle (blunt or otherwise) should never be recapped. The recommendation against recapping needles is clearly articulated in the national IPAC guidelines.

Page 2 and on page 51: Statutory Requirement. 7. It is good practice to follow safe sharp handling practices including: not passing sharps directly from hand to hand keep handling to a minimum not recapping, bending or breaking needles after use.

Page 51: In dentistry, recapping or disassembling sharps may be unavoidable. If so, a risk assessment must be undertaken and safety devices should be used where appropriate[89].

Page 52: Certainty of the Evidence. This advice is based on limited evidence, but on sound theoretical principles and supported by expert advice. National and international guidelines are consistent in the advice regarding the importance of the safe use and disposal of sharps. The Epic Guidelines[78] recommend that sharps should not be passed directly from hand to hand, and that needles must not be bent, broken or recapped.

Regards,
Lesley Lewis
Regional Infection Control Consultant HRICRCS Program
Tel: (03) 57 225486 Lesley.Lewis@nhw.org.au

From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Angela Carvosso
Sent: Friday, 4 October 2019 11:01 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up Needles

Hi Fiona,

I personally recap just to remove the needle from the syringe as I was taught to never touch the coloured hub. The premise of not recapping is to prevent transmission of infection via needlestick from needles used on people. A risk analysis would indicate that as the needle has not been used on a person then it is safe to recap.

Regards Angela Carvosso
RN Warwick Hospital

Sent from Mail for Windows 10

________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of De Sousa, Fiona M <fiona.de.sousa@THS.TAS.GOV.AU>
Sent: Wednesday, October 2, 2019 4:28:46 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] FW: Sharps Safety and Recapping Drawing up Needles

Hi All,

We are currently having discussions about how to safely draw up medications and whether it is suitable to recap a blunt fill drawing up needle to expel air from a syringe.

One side of the argument is that the blunt fill is recapped so that when air is expelled the contents are not aerosolised. The other side is that a needle (blunt or otherwise) should never be recapped.

I would be interested to know other peoples thoughts and what evidence if any you have for this.

Kind regards,

IPCU By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms

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