evaluation of needle remover devices program for appropriate technology in health balcan, uk
TRANSCRIPT
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Evaluation of Needle Remover Devices
Program for Appropriate Technology in Health
Balcan, UK
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Needle Removers• Concept• Advantages• Disadvantages• Contamination Study• Design Tradeoffs
SIGN—October 2002
Balcan, UK
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Needle remover collects needles in a secure container
Syringe bodies are put in a safety box
Needles are dumped from the container into a protected pit
Concept
Safely remove used needles from syringes
SIGN—October 2002
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Advantages• Decrease waste volume
• Decrease/contain sharps waste
• Lower cost of handling/transport
• Fewer safety boxes
• Help prevent reuse
SIGN—October 2002
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Disadvantagesoffset by...Additional cost
Supply needs
Possible splatter contamination
– Reusable containers– Bundling?
– 90% less sharps waste– Fewer safety boxes– Lower transport cost– Long life of device
– Conduct study
SIGN—October 2002
Increased handling
– Fewer sharps downstream
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Study Background
Literature shows risk of infection
– Pathogens spread by hands
– Splash to the eye
• Lauer JL, VanDrunen NA, Washburn JW, Balfour HH Jr. Transmission of hepatitis B virus in clinical laboratory areas. J Infect Dis 1979;140:513-6.• Follett EA, Sleigh JD. Hepatitis B as a hazard to laboratory staff: a re-appraisal. J Clin Pathol 1980;33:1017-20.• Levy BS, Harris JC, Smith JL, Washburn JW, Mature J, Davis A, Crosson JT, Polesky H, Hanson M. Hepatitis B in ward and clinical laboratory
employees of a general hospital. Am J Epidemiol 1977;106:330-5.• Sartori M, Terra GL, Aglietta M, Manzin A, Navino C, Verzetti G. Transmission of hepatitis C via blood splash into conjunctiva. Custom 1:
19930713 DCOM- 19930713 LR - 20001218 1993;25:270-1.• Ippolito G, Puro V, Petrosillo N, De Carli G, Micheloni G, Magliano E. Simultaneous infection with HIV and hepatitis C virus following
occupational conjunctival blood exposure. JAMA 1998;280:28.
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Design• Qualitative
• Visual Marker
• Sensitivity < 1mm diameter
SIGN—October 2002
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Method
• 0.25 ml dye solution, lumen filled
• Control drips prior to use
• Compliant use, manufacturer’s IFUs
• 20 uses per device
SIGN—October 2002
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Materials• 5 devices from 4 manufacturers
• 2 cutters, 3 pullers
• WHO Safety Box
• Pliers
SIGN—October 2002
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Results
• No splatter from any device EXCEPT...
• Pliers
SIGN—October 2002
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SIGN—October 2002
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Limits• Does not measure aerosolization
• Does not measure non-
compliant use
• One syringe size (23 gauge 1
inch)SIGN—October 2002
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Needle Removers• Concept• Advantages• Disadvantages• Contamination Study• Design Tradeoffs
SIGN—October 2002
Nomoresharps, Australia
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Design Tradeoffs• Cost vs. durability
• Portability vs. static use
• Needle container reusable
vs. disposable
• Syringe destruction
SIGN—October 2002
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Appropriate Device
• Inexpensive• Non-electric• Reliable and durable • Safe• Simple to use
SIGN—October 2002