Segner Verena, Kimbel Renate, Jochems Philipp, Heinemann André, Letzel Stephan, Wollschläger Daniel, Roßbach Bernd
Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 67, 55131, Mainz, Germany.
German Social Accident Insurance Institution for the Health and Welfare Services (BGW), Cologne, Germany.
Int Arch Occup Environ Health. 2017 Apr;90(3):275-284. doi: 10.1007/s00420-017-1196-0. Epub 2017 Jan 16.
This study aims at experimentally determining the incidence and extent of liquid releases onto the operator's hands and into the work environment during common nursing operations involving infusions.
A sequence of operations related to the preparation and administration of infusions was conducted by three subjects for 15 times each using fluorescein marked infusion solutions and two different infusion sets (standard set vs. safety-optimized set). Unintended release of liquid was quantified by glove and surface wipe sampling and HPLC/FD analysis of the samples. Operations concerning the disposal of infusions were also part of the study.
In over 90% of the simulations, a release of infusion solution was observed in a standard workflow, comprising priming and decapping the infusion set, connecting it to a peripheral intravenous (IV) cannula, and detaching it again. Based on median values (229 vs. 26 μl), the release of infusion solution was about ninefold higher when using the non-optimized standard infusion set. During decapping, a hand contamination was found in a majority of cases.
The handling of infusions may involve a risk of nurses' exposure to active agents by release of infusion solution into the work environment. According to our results with different infusion sets, exposure risks can be reduced technically and by appropriate handling. Nevertheless, hand contaminations found for both sets emphasize the necessity for additional measures such as more consistent use of protective gloves.
本研究旨在通过实验确定在涉及输液的常见护理操作过程中，液体释放到操作人员手上和工作环境中的发生率及程度。
三名受试者使用荧光素标记的输液溶液和两种不同的输液器（标准输液器与安全优化输液器），对与输液准备和给药相关的一系列操作各进行15次。通过手套和表面擦拭采样以及对样品进行高效液相色谱/荧光检测分析，对意外液体释放进行定量。涉及输液处置的操作也是本研究的一部分。
在超过90%的模拟操作中，在标准工作流程（包括输液器的预充和开封、连接到外周静脉留置针以及再次分离）中观察到输液溶液的释放。基于中位数（229 μl对26 μl），使用未优化的标准输液器时，输液溶液的释放量高出约9倍。在开封过程中，大多数情况下发现手部受到污染。
输液操作可能使护士面临因输液溶液释放到工作环境中而接触活性剂的风险。根据我们使用不同输液器的结果，通过技术手段和适当操作可以降低暴露风险。然而，两种输液器都发现了手部污染情况，这凸显了采取额外措施（如更持续地使用防护手套）的必要性。
