Injection practices among clinicians in United States health care settings

Background: Improper use of syringes, needles, and medication vials has resulted in patient-to-patient transmission of bloodborne pathogens, including hepatitis C virus. This study examined the injection practices of health care providers to identify trends and target opportunities for education on safe practices. Methods: An on-line survey was conducted in May and June 2010 of clinicians in US health care settings that prepare and/or administer parenteral medications. Results: The majority of the 5446 eligible respondents reported injection practices consistent with current recommendations. However, the following unsafe practices were identified: 6.0% "sometimes or always'' use single-dose/single-use vials for more than 1 patient; 0.9% "sometimes or always'' reuse a syringe but change the needle for use on a second patient; 15.1% reuse a syringe to enter a multidose vial and then 6.5% save that vial for use on another patient (1.1% overall). Conclusion: Unsafe injection practices represent an ongoing threat to patient safety. Ensuring safe injection practices in all health care settings will require a multifaceted approach that focuses on surveillance, oversight, enforcement, and continuing education.