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Despite recommendations from HICPAC and OSHA , outbreaks and patient exposures to potentially infectious bodily fluids continue to be reported .
● Label all clinician-prepared syringes of IV push medications
● Never pre-label empty syringes in anticipation of use
● To the maximum extent possible , purchase commercially prepared , premixed parenteral products Take steps to safeguard controlled substances :
● Stock the smallest sized container necessary to provide the typical ordered dose of a controlled substance to minimize the need for drug waste and limit the potential for diversion
● Proactively monitor controlled substance usage , waste procedures , and documentation
● Place sharps / pharmaceutical waste containers in areas where they can be consistently observed . Select containers with small openings that do not allow medication devices or waste to be shaken out , and where possible , secure containers so they cannot be easily removed
Avoid patient harm when using single- and multiple-dose vial containers :
● SDVs should be used on a single patient and should be discarded after use
● Ideally , even MDVs should be used for only 1 patient . If used for multiple doses , discard the MDV when the beyond-use-date , or the expiration date , is reached and any time the sterility of the vial is in question
Support a positive safety culture :
● Encourage staff to identify and report near miss / close call events as well as actual errors
● Share lessons learned about underlying weaknesses in processes , systems , or equipment that explain why an error happens
● Train , monitor , and coach staff on best practices
Sharps Safety
In addition to injection and medication safety , there are additional practices that can protect the worker from occupational injuries . Contaminated sharps should not be bent , recapped or removed . Sharps should be disposed of as soon as possible after use . Disposal receptacles should be puncture resistant , labeled as biohazardous , leak-proof , and closable . Containers should be located as close as possible to the area of use and be large enough to fit a contaminated sharp without bending . Additionally , these receptacles should not be allowed to overfill , as doing so prevents the lid from closing properly .
Employers should maintain a confidential sharps injury log to document percutaneous injuries from all sharps . The event reporting system should document the type and brand of device involved in the incident , the work area where the exposure incident occurred , and an explanation of how the incident occurred .
ECRI is affiliated with the Institute for Safe Medication Practices ( ISMP ), a global leader in medication safety . For more than 25 years , ISMP ’ s research and advocacy have improved clinical practices and policies to prevent critical medication safety errors and adverse events . ECRI is available to assist facilities . Visit
www . ecri . org .
Resources :
Margaret M . Miller , BS , MT ( ASCP ) M , CIC , FAPIC , is an infection preventionist with ECRI .
Christina Michalek , BS , RPh , FASHP , is a medication safety specialist at the Institute for Safe Medication Practices ( ISMP ).
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Employers should maintain a confidential sharps injury log to document percutaneous injuries from all sharps .
The event reporting system should document the type and brand of device involved in the incident , the work area where the exposure incident occurred , and an explanation of how the incident occurred .