Howanitz P J, Schifman R B
Department of Pathology and Laboratory Medicine, University of California-Los Angeles Medical Center 90024-1713.
Arch Pathol Lab Med. 1994 Oct;118(10):957-62.
We report on phlebotomists' safety practices in 683 institutions participating in the College of American Pathologists Q-Probes program. Participants inspected 38,357 phlebotomy tourniquets and 31,952 blood collection tube holders in use and found 2098 tourniquets and 2966 holders visibly contaminated with blood. In 67.8% of the institutions, at least one tourniquet or collection tube holder was contaminated. Needlestick injuries reported by phlebotomists during 1990 through 1992 were analyzed from approximately 11 million inpatient venipuncture procedures. These injuries ranged between 9.2 and 9.8 needlesticks per 100,000 venipunctures per year. Over 99% of the participants had a policy preventing recapping of needles, 45% discarded tourniquets when contaminated with blood, and 3.3% routinely assigned tourniquets to specific patients. Between 1990 and 1992, increasing frequencies of phlebotomists using gloves, replacing gloves between each inpatient phlebotomy, and handwashing after degloving were found. We cite the lack of compliance of handwashing between glove changes as suggesting need for regulatory rereview.
我们报告了参与美国病理学家学会Q-Probes项目的683家机构中采血人员的安全操作情况。参与者检查了38357条正在使用的采血止血带和31952个采血管架，发现2098条止血带和2966个采血管架有明显的血液污染。在67.8%的机构中，至少有一条止血带或采血管架被污染。分析了采血人员在1990年至1992年期间约1100万例住院静脉穿刺操作中报告的针刺伤情况。这些伤害发生率为每年每10万次静脉穿刺中有9.2至9.8次针刺伤。超过99%的参与者有防止重新盖帽的政策，45%在止血带被血液污染时丢弃，3.3%常规为特定患者分配止血带。在1990年至1992年期间，发现采血人员使用手套、在每次住院采血之间更换手套以及脱手套后洗手的频率增加。我们指出，更换手套之间洗手的依从性不足表明需要监管重新审查。
