Yassi A, McGill M L, Khokhar J B
Department of Occupational and Environmental Medicine, Health Sciences Center, Winnipeg, Manitoba, Canada.
Am J Infect Control. 1995 Apr;23(2):57-64. doi: 10.1016/0196-6553(95)90095-0.
Needlestick injury has been identified as a major cause of exposure to blood and body fluids. The heparin-lock intermittent intravenous procedure was implicated in the largest number of needlestick-related exposures (26%) at this 1100-bed tertiary care hospital, and replacement of this system was imperative. Cost concerns, however, necessitated that replacement products not increase overall hospital costs.
A needleless intravenous access system (Interlink i.v. Access System; Baxter Healthcare Corp., Parenterals Division, Deerfield, Ill.) was introduced. Effectiveness and cost-benefit of this system were analyzed by comparing needlestick injuries and their associated costs, as well as costs of relevant products and procedures, for the year before introduction of the new product with those for 1 year after implementation of the new system.
During the study period, the needleless access system was 78.7% effective in reducing intravenous line-related needlestick injuries. There was an overall reduction of 43.4% in total needlestick injuries from all procedures and events. The incremental cost to this hospital ranged from a 5.3% additional cost to a 5.7% savings, without even considering the less quantifiable benefits associated with avoidance of needlestick injury, time saved by using this product, and decreased infection rate.
When used as intended, this system was extremely effective in reducing intravenous line-related needlestick injuries, and the system does pay for itself.
针刺伤已被确认为接触血液和体液的主要原因。在这家拥有1100张床位的三级护理医院，肝素帽间歇性静脉输液操作导致的针刺相关暴露事件数量最多（占26%），因此必须更换该系统。然而，出于成本考虑，更换产品不能增加医院的总体成本。
引入了一种无针静脉输液接入系统（Interlink静脉输液接入系统；百特医疗保健公司，肠胃外事业部，伊利诺伊州迪尔菲尔德）。通过比较新产品引入前一年与新系统实施后一年的针刺伤及其相关成本，以及相关产品和操作的成本，分析了该系统的有效性和成本效益。
在研究期间，无针接入系统在减少与静脉输液管相关的针刺伤方面的有效率为78.7%。所有操作和事件导致的针刺伤总数总体减少了43.4%。这家医院的增量成本从增加5.3%到节省5.7%不等，甚至没有考虑与避免针刺伤、使用该产品节省的时间以及降低感染率相关的难以量化的益处。
按预期使用时，该系统在减少与静脉输液管相关的针刺伤方面极其有效，且该系统能够自行收回成本。
