Study finds passive safety engineered devices effective for NSI prevention

A landmark study of 22 million safety devices used in 61 French hospitals over a two-year period has confirmed the theory that passive, fully automatic safety devices offer significantly better protection against accidental needlestick injuries (NSIs) than early generation active safety technologies such as semi-automatic (push-button) devices or those with manually sliding shields or hinged caps.

This study, described in the article "Needlestick Injury Rates According to Different Types of Safety-Engineered Devices: Results of a French Multicenter Study" in the April 2010 issue of Infection Control and Hospital Epidemiology, was the first head-to-head comparison of safety-engineered devices by safety technology type. It was conducted by GERES (Groupe d'Etude sur le Risque d'Exposition des Soignants), a well-established, government-funded research group.

The study concludes that passive safety engineered devices are more effective than active devices for NSI prevention.

Among its findings, the study documents the procedure specific needlestick injury rate by safety device technology. For intravascular catheters the NSI rate for passive or fully automatic devices studied was 1.31 per 100,000 devices used, compared with 2.54 per 100,000 devices used for semi-automatic (push-button) technology and 4.34 per 100,000 devices used for manually sliding shield technology. With semi-automatic and sliding shield devices, healthcare workers can choose whether or not to operate the safety features. Passive, fully automatic devices, on the other hand, "require no input from the user" and "eliminate the need for elaborate training." According to the study, fully automatic or passive safety devices are most effective for NSI prevention. The B. Braun Medical Inc. (B. Braun) Introcan Safety® IV Catheter was one of the devices used in this study and is a market share leader in fully automatic, passive safety technology IV catheters.

"Automatic safety features in catheters are critical to reducing accidental needlestick injuries," said Lynn Hadaway, M.Ed., RN, BC, CRNI, who has more than 35 years experience in infusion nursing and adult education. "The study clearly demonstrates why healthcare facilities need to carefully select devices on the basis of their passive safety features." Hadaway recently recorded her thoughts on the significance of this study and that video can be accessed here.

Janine Jagger, Director of the International Healthcare Workers Safety Center at the University of Virginia said the study "may never be replicated because of its sheer size – involving 22 million needle devices."

"The researchers have demonstrated that devices requiring the least manipulation to cover the needles have the lowest injury rates - passive devices being the lowest," she said. "This is the same phenomenon that was first demonstrated more than 20 years ago, but with comparisons at that time to conventional needles. The technological advances since then have been amazing. We should not forget that all of these safety designs are significantly safer than conventional needles."

"This study adds a critical new layer of evidence supporting the adoption and use of safety engineered devices to prevent healthcare worker injuries and exposure to blood borne pathogens like hepatitis C and HIV. It provides conclusive evidence of the increased protection fully automatic devices provide when compared with other early generation safety-engineered devices," said Tom Sutton, Vice President, Vascular Access and IV Systems for B. Braun Medical Inc. "The study shows a passive, fully automatic safety IV catheter is about two times better than an active, semi-automatic 'push-button' safety shield and three times better than a manually sliding shield technology in preventing NSIs."

With B. Braun's Introcan Safety® IV Catheter, for example, all the user has to do is use it, as the safety mechanism does not require any extra steps for activation. There is no risk of forgetting to make the needle safe. From insertion to advancing the catheter to needle removal, clinicians are protected because they are using a fully automatic passive safety device that cannot be bypassed.

Sutton added that the GERES study is likely to influence purchasing trends as healthcare professionals evaluate the most appropriate devices for their facilities.