Reuse of Needles and Syringes by Healthcare Providers Puts Patients at Risk

11/13/2002

From: Christopher Bettin, 847-692-7050 ext. 3043, of the American Association of Nurse Anesthetists Email: cbettin@aana.com

PARK RIDGE, Ill., Nov. 13 -- A new survey of various healthcare providers who give medications through injections reveals that 1 in 100 reuse the same needle and/or syringe on multiple patients, according to the American Association of Nurse Anesthetists (AANA).

The telephone survey, conducted by Cooper Research, Inc., of Cincinnati, Ohio, included a random selection of healthcare providers in five different categories: anesthesiologists, other physicians, Certified Registered Nurse Anesthetists (CRNAs), other nurses, and oral surgeons. Prompted by recent news reports of Hepatitis C outbreaks in Brooklyn, NY, and Norman, Okla., allegedly caused by healthcare providers reusing needles and/or syringes on multiple patients, the survey was undertaken to determine provider attitudes and practices concerning reuse.

Despite infection control guidelines that advise against the reuse of needles and syringes on multiple patients, the survey results suggest that there is a lack of compliance among some healthcare providers.

"There is no excuse for ever reusing a needle or syringe on different patients," said Rodney Lester, CRNA, PhD, president of the 30,000-member AANA. "It is most disturbing that even 1 percent of the healthcare providers surveyed do this, potentially exposing millions of patients each year to needles and/or syringes contaminated with Hepatitis, HIV, or other life-threatening infectious diseases."

Among the different categories of healthcare professionals surveyed, 3 percent of the anesthesiologists who responded indicated they reuse needles and/or syringes on multiple patients; other physicians, CRNAs, other nurses and oral surgeons reported reuse at 1 percent or less for each group.

Lester pointed out that even though the percentages of healthcare providers who reuse on multiple patients appear to be low, they translate into an alarming number of actual healthcare providers. "In the anesthesia field alone," Lester said, "3 percent of physician anesthesiologists and 1 percent of CRNAs amounts to roughly 750 anesthesiologists and 250 nurse anesthetists, or a total of 1,000 providers. That is 1,000 too many."

According to Lester, reuse of the same needle and/or syringe on multiple patients is strictly forbidden in the infection control guidelines and practice standards of various professional associations, such as the AANA, American Society of Anesthesiologists, and Association for Professionals in Infection Control and Epidemiology, Inc. He added that using the same needle and syringe on multiple patients is not allowed regardless of whether the provider uses needles or a needleless system to administer medications. Many healthcare facilities have gone to needleless systems in recent years as a safeguard against contamination and as a precaution against needlesticks for healthcare providers. However, even with needleless systems the reuse of syringes from patient to patient is not permissible.

"Plain old common sense dictates that the safest practice is single use, then disposal," Lester emphasized.

The survey also suggests that the reuse of a needle and/or syringe on the same patient is somewhat of a gray area for healthcare providers. Thirty-one percent of the survey respondents who only use needles (and syringes) indicated that they reuse on the same patient. The percentage jumps to 35 percent when taking into account providers using needleless systems, in which case the syringe would be reused on the same patient. Discussion among healthcare professionals about the appropriateness of reuse with needleless systems is ongoing.

In contrast, 57 percent of the healthcare providers surveyed responded "no" when asked, "Are there any circumstances when it is acceptable to reuse syringes or needles?"

The two cases that prompted the survey have received extensive media coverage. Last spring, the story broke that a physician anesthesiologist in Brooklyn allegedly infected 19 patients with Hepatitis C through the reuse of needles. More recently, the media reported that a CRNA working at a pain clinic in Norman allegedly infected as many as 52 patients with Hepatitis C by reusing needles/syringes.

The latest incident of a Hepatitis outbreak, allegedly related to needle and syringe reuse by a physician, was reported in October at a cancer clinic in Omaha, Neb.

Lester said the telephone survey is just the starting point. "Clearly, the results indicate a great need for extensive research on infection control guidelines and compliance, as well as an investigation of the use of needleless systems and whether these systems clearly reduce the chance of spreading infection," he said.

"The AANA is taking a proactive approach to this problem, which extends across all of healthcare. In addition to advocating for additional research, the AANA is working with other healthcare organizations to address the issue. The association is also developing a public education campaign to make patients and their families aware of standards for needle and syringe reuse. The public deserves to know what they should expect from their healthcare providers when they enter a doctor's office, hospital, or other facility."

Lester had the following recommendation for patients: "If you are going to have surgery or any other procedure that might involve receiving medication through a needle and/or syringe, consult with your healthcare providers about their personal attitude and practice habits concerning the use of needles and syringes."

The Cooper study reflected the opinions of healthcare providers from 48 states. One healthcare provider per facility was used for the survey.

------ About the American Association of Nurse Anesthetists Founded in 1931 and located in Park Ridge, III., the AANA is the professional association for more than 30,000 CRNAs. As advanced practice nurses, CRNAs administer approximately 65 percent of the 26 million anesthetics delivered in the United States each year. CRNAs practice in every setting where anesthesia is available and are the sole anesthesia providers in more than two-thirds of all rural hospitals.