Why re-use a syringe?

The answer is YOU DON’T !! Not in any circustance should nurses and any other healthcare providers re-use a disposable syringe. Disposable syringes are single use only! This seem like a no brainer, right ? Then you see news like this…(Click on the image below to read the news article )

 

Re-usesyringe

 

What? Did I hear you say…seriously??? SERIOUSLY??? Yeah, that’s what I said too!

This isnt the first time we’ve heard about syringe re-use resulting in patient harm. Sad but it is the truth.  Perhaps there are healthcare providers who think syringe re-use is common practice and because we don’t hear about the consequences of their poor practice (or they’re not even aware)  they continue to re-use single use syringes.

If you’ve been a follower/reader of my blog, you know how much I have written about NOT RE-USING SYRINGES (since 2009)!!!!! I thought I was preaching to the choir but there’s still a lot of education to do and let’s stop this poor practice!

Here are a few important points from previous blog posts on WHY YOU SHOULD NOT RE-USE SYRINGES!

  • Look at the syringe packaging label – SINGLE USE ONLY!!syringe1-m
  • Look at another syringe label – DO NOT REUSE! Note the symbol above the words (crossed 2) means DO NOT REUSE!20141028_111123
  • And it even tells us what to do –  DISCARD AFTER SINGLE USE

syringe2-m

  • Pay atention to the label – it’s there for a reason!! Disclosure: The pictures are intended to show the label on the product or packaging only and not intended to implicate the manufacturer of the device.

 

  • The definition from the CDRH (Centers for Devices and Radiologic Health, a division of the FDA) of a single-use device, also referred to as a disposable device, is intended for use on one patient during a single procedure. It is not intended to be reprocessed (cleaned, disinfected/sterilized) and used on another patient. The labeling may or may not identify the device as single use or disposable and does not include instructions for reprocessing.

 

  • The CDC has launched a campaign called “One and Only” to raise awareness among patients and healthcare providers about safe injection practices. The campaign aims to eradicate outbreaks resulting from unsafe injection practices. For more information on this campaign, go to their website – http://www.oneandonlycampaign.org.

 

  • Here’s a video on Safe Injection Practices (from the oneandonlycampaign) , I think all nurses and other healthcare providers should view, regardless of how long we have been practicing.  Let’s educate everyone and spread the word on safe injection practices https://www.youtube.com/watch?time_continue=51&v=SobWZE4uRrs

 

 

  •  Nurses and other healthcare providers should know but have to be reminded that “single use” is really “single use”.  In case you’re not sure when a single use syringe is considered used? Read this…
    • When the syringe is taken out of the sterile  packaging and the plunger is pulled  to withdraw the medication, then pushed completely in to expel the syringe content,  the internal barrel of the syringe is considered contaminated and must be discarded appropriately.  Any microorganisms, which might be placed onto the sides  (ribs) of a syringe plunger by finger contact while withdrawing the plunger, can be transferred to the inside of the barrel and enter the fluid pathway if the plunger is drawn in and out several times.  A syringe must only  be used once to draw up medication, and must not be used again even to draw up the same medication, from the same vial, for the same patient.
    • If you observe a nurse withdrawing fluid from a vial with a syringe, take note of where that person’s fingers are on the plunger of the syringe. Many have their fingers/palm wrapped around “ribs” of the plunger, with or without gloves, as they are pulling the fluid into the syringe. Once the syringe is full, then the plunger (where fingers were wrapped) now is pushed into the barrel of the syringe until empty. Imagine this scenario over and over when the same syringe is used over and over.

 

I get “cost effectiveness” but not when it compromises sterility and good infection control practices.  Many have told me that this practice is not illegal, but is it ethical? As registered nurses, we have a duty to do no harm and to promote good and act in the best interest of our patients. There is no doubt that reuse of single use only devices has a direct impact on patient safety, increased infection risk, and threat to product quality. Would you reuse a syringe if the patient is your mother or loved one?

What about the nurse in the case above?  I believe no nurse will “deliberately” harm a patient, unfortunately, this nurse who should know better, fell into this poor practice. Be smart, don’t re-use syringes!

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References:

  1. Arnold S, Melville SK, Morehead B, Vaughan G, Moorman A, Crist MB. Notes from the Field. Hepatitis C Transmission from Inappropriate Reuse of Saline Flush Syringes for Multiple Patients in an Acute Care General Hospital — Texas, 2015. MMWR Morb Mortal Wkly Rep 2017;66:258–260. DOI: http://dx.doi.org/10.15585/mmwr.mm6609a4
  2. Labeling Recommendations for Single-Use Devices Reprocessed by Third Parties and Hospitals; Final Guidance for Industry and FDA (July 30, 2001), available at http://www.fda.gov/cdrh/comp/guidance/1392.html

 

Related posts by infusion nurse blog:

  1.  SINGLE USE ONLY – https://infusionnurse.org/2010/02/05/single-use-only/
  2.  Q&A: Syringe Reuse – https://infusionnurse.org/2013/04/16/qa-syringe-re-use/
  3. Our patients notice what we do – https://infusionnurse.org/2011/08/16/our-patients-notice-what-we-do/
  4. Q&A: When is a single use considered used? – https://infusionnurse.org/2014/07/01/qa-when-is-a-single-use-syringe-considered-used/
  5. Single use only = Safe Injection Practices – https://infusionnurse.org/2011/05/03/single-use-only-safe-injection-practices/