Evaluation of institutional practices for prevention of phlebotomy-associated percutaneous injuries in hospital settings.

BACKGROUND: To reduce the incidence of phlebotomy-related percutaneous injuries (PIs), factors that contribute to these injuries must be identified. This study examined institutional phlebotomy practices, policies, perceptions, and culture to identify facilitators and barriers that appear to have the greatest impact in preventing injuries. METHODS: During site visits at study hospitals, observational data were collected during the performance of phlebotomy. In addition, interviews and focus groups were conducted with hospital personnel involved in phlebotomy procedures. RESULTS: Nine hospitals participated in the study. A total of 126 phlebotomy procedures were observed. Health care personnel chose devices with safety features for the majority of observed procedures (n = 122, 97%). Recommended phlebotomy practices for handling needles after use were observed in 42% to 92% of procedures. Adherence varied by type of device, occupation, and facility PI rate. In the 23 interviews and 9 focus groups, participants identified factors that facilitated PI prevention such as the availability and use of devices with safety mechanisms, adherence to recommended safe needle-handling practices, and institutional phlebotomy training. CONCLUSION: The quantitative and qualitative data indicate that a wide array of factors can affect phlebotomy-related practices and perceptions. Prevention of PIs may require comprehensive, multifaceted intervention efforts to improve the safety culture and reduce PIs and exposure to bloodborne pathogens in health care facilities.

Assessment of health care personnel needs for training in infection control: one size does not fit all.

To guide development of infection control education, we conducted a pilot needs assessment to determine current infection control knowledge, identify potential gaps between knowledge and practice, and identify perceived training needs among a varied group of health care personnel. A total of 23 health care personnel from various disciplines and health care settings completed the self-administered Web-based survey. Differences in knowledge and self-identified training needs were found among disciplines. Future research may well focus on further exploring specific needs of different disciplines. These results will be used to inform topics to cover in infection control curricula for clinicians, public health professionals, and allied health personnel.