SRNAs/CRNAs - needle safety question

Athlein · Jul 23, 2003

Thanks for your imput, CRNA, DNSc. I agree that if the statement is indeed valid, it is merely one of a constellation of factors that influence chemical use in anesthesia providers.

Rather than covering chemical dependency issues in my project, I am thinking about needle safety. Call it lack of needle taboo, complacency, familiarity, etc. We're still getting stuck, even when we are working with high-risk patients. But why?

Qwiigley, BSN, MSN, DNP, RN, CRNA · Jul 25, 2003

The clinical sites that I have been to are going overboard with safety. It's hard to find a needle to be able to access vials that need a needle. It can be frustrating. At CHLA they have these port access devices that are like a really thick needle, saying that they are less likely to puncture intact skin. They could do some serious harm if you are not careful and in a hurry.

Most everyone is using safety needles.

As for chemical abuse, at this point I haven't seen any, but have heard about some thru the grapevine. I am personally afraid of needles. I can't even give myself an accucheck! Ouch!

Athlein · Aug 2, 2003

Hey Qwiigley,

You are at Kaiser, correct? If so, is Kaiser using the interlink system? That's the one with the special ports on the IV tubing and the access syringes that have the little blue arrow-thingys. Are the work carts not even being stocked with non-safety needles?

I have been doing the research for almost two weeks, and I am dismayed by how many MDAs and CRNAs are still using non-safety needles, even when it is hospital policy that a needleless system is to be used.

Thanks in advance for your reply!

Pete495 · Aug 2, 2003

I know personally that the docs and CRNA's in our hospital use safety syringes. In other words, they use a needle to draw it up, but the syringe to inject the medication. How else are you supposed to draw up that cardizem or whatever? Since medications in the OR have to be given so quickly, it is necessary to have the ability to draw up whatever one needs at that particular moment. To take away this ability with the discontinuation of needles hinders CRNA's and MDA's from performing these tasks quickly. Let's face it. Some of our nurses and docs are just old school, and prefer to do it the way they know how to do it. I still find my self using needles sometimes in my critical care unit to draw out of arterial lines even though we have the non-needleless system available for use. Sometimes if all you need is a glucose, you just use a needle and syringe because it is quicker and the result is faster.

As far as reuse, I've never seen anybody actually do it. It seems that one bird makes it bad for the whole flock, because the poop is flying downhill after this whole Oklahoma incident, and now MDA's and CRNA's are scrutinized to the tilt. There have been other instances, but who can say this is a blanket problem when no studies have been done. Or am I nieve that no studies have been done on this, and I just don't know about them?

I don't think it's a cavelier attitude toward needle stick injuries. I simply believe that the quickest method to deliver meds to a patient is utilized, and providers stick to the method they are most comfortable using, a method that they have been using for several years. Maybe they are just resistant to change, and this is part of the problem. Sometimes, drawing up, capping, recapping, then getting your needleless device does take a lot of time, especially when you're in the operating room where time is so critical.