By Cole Petrochko, Staff Writer, MedPage Today
Published: May 30, 2013
With the stated goal of increasing injection safety, the CDC unveiled a new set of guidelines powered by a catchy phrase -- "the four Es" and then worked to tailor a set of clunky descriptions phrase.
The "Es" in question are:
- Epidemiologic surveillance of unsafe injection
- Enforcement of safe practices
- Engineering devices to reduce risks
Among safe injection practices that help prevent the spread of disease, healthcare professionals should never administer medications from the same syringe or single-dose vial to multiple patients, nor should they enter a vial with a used syringe or needle, wrote Joseph Perz, DrPH, of the CDC, and co-authors online in Morbidity and Mortality Weekly Report.
"The U.S. experience with outbreaks attributed to unsafe injection practices has grown substantially over recent years," the authors said, noting at least 49 outbreaks since 2001 attributable to "extrinsic contamination of injectable medical products at the point of administration," the majority of which involved hepatitis B or C, but also included bacterial and invasive bloodstream infections.
The guidelines classified unsafe injection practices into two categories: reuse of syringes and mishandling of injectable drugs.
Syringe reuse was further broken down into direct and indirect reuse. Direct reuse involves injecting multiple patients with a single syringe, while indirect reuse involves using multiple syringes through a shared medication vial.
The authors identified mishandling of medication as using single-dose vials and intravenous solution bags to treat multiple patients.
The authors concluded with a caution that unsafe injection practices are not limited to any one procedure or setting, and that unsafe injection practices increase fiscal and emotional burdens, as well as disease burdens, for patients, practitioners, and public health and medical care systems. Despite these risks, they noted, the problem is entirely preventable.
The authors declared no conflicts of interest.
Primary source: Morbidity and Mortality Weekly Report
Perz J, et al "CDC grand rounds: preventing unsafe injection practices in the U.S. health-care system" MMWR 2013; 62(21): 423-425.