Simulated evaluation of a non-Luer safety connector system for use in neuraxial procedures.

BACKGROUND: Spinal syringes, needles, and other devices with connectors that will not also connect with Luer devices could substantially reduce wrong-route drug administration errors. This study aimed to evaluate a newly designed non-Luer safety connector system for neuraxial procedures in terms of clinical acceptability and cross-connectivity with conventional Luer devices. METHODS: A non-Luer safety connector system (BD UniVia-6 Safety Connector system), which included non-Luer spinal needles, syringes, and blunt fill filter needles, was evaluated in a prospective, simulated use, randomized study. Clinicians evaluated the acceptability and performance characteristics using a normal saline injectate on an artificial back model. RESULTS: Forty-nine clinicians participated in the study. For 93 of 98 spinal injection procedures, clinicians agreed that overall, the safety system was clinically acceptable (94.9%; 95% lower bound 89.6%). Forty-eight clinicians (98%; 95% lower bound: 90.7%) agreed that the safety system prevented or reduced the risk of misconnection between a conventional syringe and a safety spinal needle. A lower proportion (63.3%; 95% lower bound: 50.5%) agreed that the safety system would prevent or reduce the risk of misconnections between a safety syringe filled with medication intended for spinal injection and an i.v. Luer device. CONCLUSIONS: Our study demonstrated that study clinicians found the safety system to be acceptable with minimal impact on technique in a simulated-use setting. The non-Luer system also appeared to decrease the risk of administration of i.v. medications into the intrathecal space. Further modifications will be required to completely eliminate the risk of administering intrathecal medication i.v. and evaluation in a clinical setting will help determine the true impact of this non-Luer system on patient safety.

Peripheral intravenous catheter use in Europe: towards the use of safety devices.

BACKGROUND: Peripheral intravenous catheters are among the most widely used medical devices in the world. European patients are increasingly aware of the risk of health care associated infections and the role catheters play in their facilitation. AIMS: We intend to show that European health care providers are increasingly aware of the occupational risks of bloodborne infections such as HIV and hepatitis which can be transmitted by the needles from catheters and that the political will is building to take action to ensure safer devices are provided. METHODS: We review the wide variety of peripheral intravenous catheters which are specially engineered to reduce these risks. RESULTS: Available safety devices include spring-loaded retractable needles, guards that shield the dangerous tips and closed, needle-free access valves for intravenous sets. CONCLUSIONS: It is no longer necessary for patients and professionals to take risks to health and life when solutions which minimize these risks are at hand.

The challenges of involving traditional healers in HIV/AIDS care.

In sub-Saharan Africa, traditional healers play a major role in providing for the needs of people, particularly in rural areas where western health care is unavailable. Despite a paucity of reliable figures to determine the prevalence of traditional medicine usage, it is estimated that some 70% of sub-Saharan Africans access traditional healers. There is now mounting evidence of the importance of involving traditional healers in the management of the HIV/AIDS epidemic--both for their potential benefits, although poorly researched and understood, and to reduce the impact that some traditional healing interventions may play on the spread of HIV/AIDS and unsafe treatment of infected patients. While there are few collaborative projects between traditional healers and biomedical health providers, there is an enthusiasm on the part of traditional healers to collaborate and learn from their western-trained counterparts. Collaboration is essential, given the changing epidemic of HIV and the dynamic relationship between the two health sectors.