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FW: Sharps Safety and Recapping Drawing up Needles

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  • #75865
    Anonymous
    Inactive

    Author:
    Anonymous

    Position:

    Organisation:

    State:

    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 people’s thoughts and what evidence if any you have for this.

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
    Launceston General Hospital, Level 2, Launceston TAS 7250
    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

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

    ________________________________

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    #75867
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Position:
    Director

    Organisation:
    Grimmond and Associates, Microbiology Consultants

    State:
    Waikato

    Hi Fiona,

    Ive seen no data or guidance on capping draw-ups to prevent
    aerosolization. However, it is my recommendation that the *NEVER cap a
    needle* policy be applied universally. Otherwise staff get impression
    Its OK to recap *some* needles.

    My Australian sharps-container audit studies in 2012/13 showed 31% of
    standard needles or syringe-needles were capped (hopefully this has
    decreased), and the 2017 & 2018 EPINet studies in USA showed 2-3% of all
    sharps injuries occurred during recapping.

    Such a simple work-practice rule to *NEVER cap a needle* is still not
    universally applied and should be.

    Kind regards, Terry

    Terry Grimmond FASM, BAgrSc, GrDpAdEd

    Consultant Microbiologist

    Grimmond and Associates

    Ph (NZ): +64 7 855 3212

    Mob (NZ): +64 274 365 140

    E: terry@terrygrimmond.com

    [image: Twitter_logo_blue]: https://twitter.com/terrygrimmond

    W: http://terrygrimmond.com

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    *From:* ACIPC Infexion Connexion *On Behalf Of *De
    Sousa, Fiona M
    *Sent:* Wednesday, October 2, 2019 7:29 PM
    *To:* 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,

    *Fiona De Sousa CICP-E| *Nurse Manager *|* Infection Prevention & Control
    Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 *| mobile: *0408 487 197 *| *fax: 6777 5170 *|* email:
    fiona.de.sousa@ths.tas.gov.au *|*

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

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

    ——————————

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    #75872
    Emma Trippe
    Participant

    Author:
    Emma Trippe

    Position:

    Organisation:

    State:

    Hi Fiona we remove blunt needles post drawing up & place a “red cap’ on in line with AnTT practices . We tell all staff not to recap any needle .
    Thanks Emma

    Emma Trippe
    Infection Control Consultant
    [cid:image001.png@01D57A92.BC3E48B0]
    Calvary Riverina Hospital
    Hardy Avenue Wagga Wagga NSW 2650
    P: 02 6932 1628
    E: Emma.Trippe@calvarycare.org.au
    http://www.calvary-wagga.com.au

    Hospitality | Healing | Stewardship | Respect
    Continuing the Mission of the Sisters of the Little Company of Mary

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    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 people’s thoughts and what evidence if any you have for this.

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
    Launceston General Hospital, Level 2, Launceston TAS 7250
    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

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

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #75873
    Angela Carvosso
    Participant

    Author:
    Angela Carvosso

    Position:
    Registered Nurse

    Organisation:
    Sunshine Coast University Hospital

    State:

    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

    ________________________________

    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,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
    Launceston General Hospital, Level 2, Launceston TAS 7250
    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

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

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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    #75890
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    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

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    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,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
    Launceston General Hospital, Level 2, Launceston TAS 7250
    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

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

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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