Ditch the Pinch: Bilateral Exposure Injuries During Subcutaneous Injection

2.50
Hdl Handle:
http://hdl.handle.net/10755/308416
Category:
Abstract
Type:
Presentation
Title:
Ditch the Pinch: Bilateral Exposure Injuries During Subcutaneous Injection
Author(s):
Black, Lisa M
Lead Author STTI Affiliation:
Nu Iota
Author Details:
Lisa M Black, PhD, RN, CNE, lblack@unr.edu
Abstract:

Session presented on: Monday, November 18, 2013

Purpose

Subcutaneous injection of medication into an elevated (“pinched”) skin fold poses a risk of ‘bilateral exposure’ injury whereby the needle pierces the opposite side of a skin fold and subsequently enters the tissue of the healthcare worker. The needle must then be withdrawn from both the patient and the HCW; simultaneously exposing each to the blood of the other.  The purpose of this research is to describe factors contributing to bilateral bloodborne pathogen (BBP) exposure injuries among healthcare providers in acute care settings.

Methods

Narrative injury data from 2,402 percutaneous injuries that occurred during the administration of subcutaneous injections between the years 2000 and 2009 were examined to identify factors that contribute to bilateral exposure injuries. Descriptive and multivariate logistic regression analyses were performed.

Results

Eighty-five bilateral exposure injuries were identified between 2000 and 2009, representing 3.5% (n/N = 85/2,402) of all percutaneous injuries occurring during subcutaneous injection. Nurses and nursing students administered 73% (n/N 1,751/2,398) of all subcutaneous injections that resulted in a percutaneous injury, and 4.6% (n/N = 81/1,751) of injuries to nurses resulted in a bilateral exposure. Sixty-five percent of the variance in bilateral exposure injury occurrence is explained through examination of: (1) manual elevation of subcutaneous tissue prior to injection; (2) thin/emaciated patient; (3) injection of insulin, heparin, enoxaparin; (6) whether a safety device was used; and (7) whether the healthcare worker was wearing gloves at the time of the injury (X2(7) = 424.2; p < 0.01). 

Conclusions

While ubiquitously used, manual skinfold elevation potentially places both the health care worker and the patient at risk for exposure to bloodborne disease. The risk of bilateral bloodborne pathogen exposure injuries could be minimized through the use of appropriately-sized needles that permit injection into the subcutaneous tissue without the need for a manually elevated skin fold.

Keywords:
Bilateral Exposure; Patient BBP exposure; Needlestick Injury
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDitch the Pinch: Bilateral Exposure Injuries During Subcutaneous Injectionen_GB
dc.contributor.authorBlack, Lisa Men_GB
dc.contributor.departmentNu Iotaen_GB
dc.author.detailsLisa M Black, PhD, RN, CNE, lblack@unr.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308416-
dc.description.abstract<p>Session presented on: Monday, November 18, 2013</p><b>Purpose</b><p>Subcutaneous injection of medication into an elevated (“pinched”) skin fold poses a risk of ‘bilateral exposure’ injury whereby the needle pierces the opposite side of a skin fold and subsequently enters the tissue of the healthcare worker. The needle must then be withdrawn from both the patient and the HCW; simultaneously exposing each to the blood of the other.  The purpose of this research is to describe factors contributing to bilateral bloodborne pathogen (BBP) exposure injuries among healthcare providers in acute care settings. <p><b>Methods</b><p>Narrative injury data from 2,402 percutaneous injuries that occurred during the administration of subcutaneous injections between the years 2000 and 2009 were examined to identify factors that contribute to bilateral exposure injuries. Descriptive and multivariate logistic regression analyses were performed. <p><b>Results</b><p>Eighty-five bilateral exposure injuries were identified between 2000 and 2009, representing 3.5% (n/N = 85/2,402) of all percutaneous injuries occurring during subcutaneous injection. Nurses and nursing students administered 73% (n/N 1,751/2,398) of all subcutaneous injections that resulted in a percutaneous injury, and 4.6% (n/N = 81/1,751) of injuries to nurses resulted in a bilateral exposure. Sixty-five percent of the variance in bilateral exposure injury occurrence is explained through examination of: (1) manual elevation of subcutaneous tissue prior to injection; (2) thin/emaciated patient; (3) injection of insulin, heparin, enoxaparin; (6) whether a safety device was used; and (7) whether the healthcare worker was wearing gloves at the time of the injury (X<sup>2</sup>(7) = 424.2; p < 0.01).  <p><b>Conclusions</b><p>While ubiquitously used, manual skinfold elevation potentially places both the health care worker and the patient at risk for exposure to bloodborne disease. The risk of bilateral bloodborne pathogen exposure injuries could be minimized through the use of appropriately-sized needles that permit injection into the subcutaneous tissue without the need for a manually elevated skin fold.en_GB
dc.subjectBilateral Exposureen_GB
dc.subjectPatient BBP exposureen_GB
dc.subjectNeedlestick Injuryen_GB
dc.date.available2013-12-19T17:31:02Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:31:02Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
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