Be safe Don't Get Stuck

Needle sticks in healthcare and other occupational settings definitely continue to be a serious problem. In 2000, the Needlestick Safety and Prevention Act was signed into law by congress. This law amended the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogen Standard, giving more specific details involving safer needle devices. States and territories that govern their own OSHA programs, also must adopt these revisions.

Needlestick wounds are caused by a needle that accidentally punctures the skin. This is a definite hazard for healthcare workers that work with hypodermic syringes or other equipment that has a needle. These sticks can occur at any time, the worker may be preparing the needle for the injection or disassembling or disposing of the needle. Needles are often thrown into the garbage or linen instead of being properly disposed of and therefore injure other workers, who encounter them unexpectedly.

In spite of all the guidelines and educational training programs for the healthcare professionals, needlesticks continue to be an ongoing problem. The bloodborne infectious diseases are considered to be HIV/Aids, Hepatitis B, and Hepatitis C. Healthcare professionals are strongly encouraged to use blunt-tip suture needles or needle free systems in order to decrease the risk of a needlestick injury. Hazardous fluids can be injected into the workers body by an accidental stick that punctures the skin.

Wolf-Pak provides valves for use with intravenous tubing's, which are one piece, luer-activated valves. They are easy to swab and come as a stand-alone piece or with an extension set pre-attached. These come in 100/box. The smartsite valve is one of the most widely used in the world. This valve, increases compliance and does away with the need for caps and cannulas. These valves are latex free and are suitable for a wide variety of drugs.

The major reason that simple solutions fail to stop the problem is that needles can cause injuries at any stage of their use. The design of the equipment, the type of the procedure, the experience of the staff, recapping, and the disposal of needles, are all factors that influence the reoccurring needle sticks. Approximately 30 to 50% of the needlestick injuries incurred are by nursing and laboratory staff. More than 30% of these injuries occur when the staff is disposing of the needles in sharp containers. The highest accounts of incidents occur because the sharp containers are overfilled.

All facilities have policies in place for the changing of the sharp containers and these policies should be carefully followed by all personnel. If you receive a needlestick, always report it to the proper people. Follow the guidelines and procedures of your facility. When using sharps such as needles or any other type of sharps, always be careful, follow policies and think before you act.

Diabetes And The Insulin Pump

Diabetes is a disease of the metabolic system, in which the patient has high blood sugar. In some cases, the pancreas doesn't produce enough insulin and in other cases, the cells just don't respond to the insulin when it is produced. This high blood sugar can cause a multitude of problems. The classical symptoms of diabetes is frequent urination, hunger, and increase in thirst.

There are 2 different types of diabetes.

Type 1 occurs because the pancreas does not make enough insulin.

Type 2 occurs because the cells in the body do not use the insulin in the right way.

Gestational occurs when a woman is pregnant and develops diabetes, when she did not have it before her pregnancy. Treatment for diabetes can range from controlling diet, oral medications, insulin injections and insulin pumps. Gastric bypass surgery has been known to help with people who have diabetes because of severe obesity and the gestational diabetic, usually resolves after the birth of the baby.

The insulin pumps replace the need to have injections. The pump delivers rapid acting insulin throughout the day by the use of a catheter. When the pump is used, the insulin can be better matched to the lifestyle. When the insulin pumps were first used, they were used more by the patients that were Type 1 diabetics, but now are being used more by people with Type 2 diabetes. The pump does not work by itself, it must be programed. The pump has to be told to deliver the insulin after the blood sugar is checked.

One type of Insulin infusion pump set is the Paradigm , which is used with the MiniMed Paradigm pumps. The user-filled reservoir holds up to 3 ml of insulin and come 10/box. The insulin pump is a small computerized device, similar in size to a cell phone, which is worn on a belt or pocket. This pump allows for the continuous flow of a rapid acting insulin. The insulin enters the body through a catheter that is inserted under the skin of the abdomen and is then taped down. The average insulin pump costs approximately $6,000 and many of the insurance companies have very strict guidelines that have to be followed.

The insulin pump provides a slow release of insulin, similar to what a normal pancreas would do and the thought is that it provides better blood sugars than with a number of injections given throughout the day. Another advantage is that there is no measuring and administering of injections. The one thing that the pump does not help with is that you still have to check your blood sugars at least 4 times a day. The pump catheter set has to be changed every couple of days and you have to be faithful in counting the grams of carbohydrates that you eat. The more successful diabetics that uses an insulin pump are ones that have been giving themselves two shots or less a day. These people tend to have less trouble with their blood sugars. The most important thing with an insulin pump is that the diabetic that is using it has a good knowledge of the procedures they need to follow.

With the insulin pumps, it can take a period of time for adjustment. The possibility of the blood sugar going high if something happens with the insulin pump or catheter can be a problem. The use of the insulin pump depends on the counting of the carbohydrates that are consumed. If the carbohydrates are not being counted, then the pump may not give good control. There is also a potential for infection of the area where the catheter in placed. This is one of the main reasons that people stop using pumps.

Although it is true, that insulin pumps are not for everyone, the fact remains that the most important part of the pump is the diabetic that is using it. Training, counting of carbohydrates, and checking the blood sugar is a must. A lot of people feel that the pump makes their diabetes easier to live with and keeps their blood sugars closer to the normal range.

Managing Of Hospital Medical Supplies

Healthcare organizations work extremely hard to contain the cost of the medical supplies that are required for appropriate patient care. With the cost of these supplies constantly rising, the management of the supplies, become more and more important. New systems are constantly being implemented to help track the supplies that are used, but this is a very difficult thing to do in a hospital or clinic setting.

Hospital medical supplies cover an extremely wide array of articles. Just a few of the supplies are dressing change IV kits, IV care kits, IV tubing's, IV catheters, and gauze. The number of supplies that are tracked are endless. Medical staff have a long history of not being the greatest at charging for these supplies. They have patient care on their minds and the charging of supplies is not high on their priority list.

Each facility has its own system for tracking of supplies and most of the time it is the size of the facility that determines how complex this system is. Education of the staff is also highly important when it comes to the documentation of supplies used. One of the simplest of systems used to track the medical supplies is by the sticker system. This consists of a coded sticky tag on each article that is to be removed and placed on a patient's charge sheet when the item is used.

Over the years, there have been many systems tried in order to make sure these items where charged for. Many times these systems are not an improvement over what was being used. The cost of supplies that are not documented for charge are lost revenue for the hospital.

It is almost impossible to determine waste, reorder, and replenish supplies, if the supplies are not measured and charged for. There is now a new system that some facilities are trying in order to accomplish the control of supplies. A Radio Frequency Identification system, works by the placement of radio tags on the supplies. The system can then track the supplies where ever they go. This system has proven to work better to identify the article and the last user of the supply, which reduces the inventory loss.

This is just another system that is being tried in order to manage hospital medical supplies. The answer to the problems with the tracking of these supplies is not an easy one, especially when you have staff and patients both involved in the mix. The new health laws and money cuts, only add to this mixture and makes the management of medical supplies even more important.

For The Love Of Disposable Medical Supplies

The enforcement of infection prevention regulations and the increase in the volume of procedures that are done at hospitals and out-patient facilities, is increasing the demand for disposable medical supplies. Because of the increase in the global demand, the manufacturers are seeing an increase in the orders for these supplies and the average annual growth rate is constantly going up.

The increase that is being seen in the end-stage kidney failure patients, is causing a rise in the therapeutic treatment of dialysis. The disposable dialysis supplies has seen the fastest increases in global demand. Medication delivery is another area that is seeing a fast growth for disposable medical supplies.

A very well-known form of the disposable medical supplies is the gloves. Forty years ago, it was not uncommon to have only a box or two of gloves in a hospital. Gloves were only worn when the clean-up was extremely bad. Today, the staff at a hospital wear gloves when doing almost everything.

Different types of gloves are available, such as NitriSkin Plus Nitrile Sterile Surgical gloves. These gloves are available in an assortment of sizes and are latex and powder free. The NitriSkin Plus gloves are approved for use with Chemotherapy drugs. Because of the soft, highly elastic formulation of the gloves, they offer a great deal of tactile sensitivity.

Gloves Nitrile/Aloe vera gloves, sooth and moisturize hands. These are powder free and recommended for areas that involve a lot of wear and tear on gloves, such as the emergency room or trauma units. The Nitrile/Aloe vera gloves have greater resistance than the latex or vinyl gloves. This is just a couple of the types of gloves available for use. There are exam gloves, vinyl gloves, latex free exam gloves, and individually packaged sterile gloves for surgery and other procedures.

Disposable gloves are only one of the types of disposable medical supplies that are available. Syringes, needles, pillowcases, pillows, thermometer covers, sharp containers, and the list goes on and on. Always check the protocols at the facility, to know the appropriate manner to dispose of the these supplies. Safety is the most important thing to take into consideration. There are usually special waste bins designated for the disposal of medical supplies, that reduce the chance of someone getting hurt.

The Changing Of The Medication World With Prefilled Syringes

The medical field has certainly changed over the years and one of the most important areas that we have seen change, is with the dispensing of medications. Before 1980, prefilled syringes were never seen. Because of the changing of the medication systems all over the world, the prefilled syringes have certainly increased the accuracy in dosing and made it more convenient for the nurses and patients.

Not all medications are made available in prefilled syringes at this time, but some available ones are heparin flushes and normal saline flushes, which are used to flush infusion locks. Posiflush Heparin flushes are available in 3 or 5 ml 10 unit BD heparin lock flush syringes or 100 unit BD heparin lock flush syringes. These syringes are latex and preservative free. They are cost effective alternatives to the vial-based systems. The use of these prefilled syringes allow for better care practices with IV therapy. The Posiflush heparin flushes come 30/box.

Posiflush Sodium Chloride prefilled syringes are available in 3, 5, and 10 ml syringes. These are latex and preservative free and provide convenient, reliable, and cost effective alternatives to the vial based system. These are available 30/box.

These prefilled syringes are not for multiple use. They are for one time use only and then are to be disposed of. The normal prefilled syringe contains the medicine in the syringe section with a plastic cap that covers the needle to prevent contamination and accidental needle sticks. It is very important to follow the protocols of the facility for the use and disposal of these syringes.

The market for the increase in the use of prefilled syringes is growing. The fact that these syringes are disposable and cannot be re-used, has definitely stimulated an interest in increasing the sale of more medications that are prefilled. With the healthy growth of interest in recent years, the pharmaceutical companies are beginning to distribute more and more medications that are in prefilled syringes. More categories, such as vaccines, erythroproteins, interferons, rheumatoid arthritis medications, and blood stimulants are increasingly leaning toward the prefilled syringes, with security being the main reason.

Prefilled syringes provide more patient safety because it helps to prevent needle sticks and also provides less chance of contamination, which usually occurred when medications were being drawn up from vials. The prefilled syringes also help to prevent dosing errors and increase the patient compliance because of the convenience and ease of use. The healthcare reform, with the cost containment and the changing of medical practices, are helping to drive the need for the increase of medications in prefilled syringes.

The Use Of Huber Needles

There are circumstances that arise when patients need to have a venous access available for such procedures as medications, blood products, drawing of blood, and total parenteral nutrition. Such illnesses as cancer, kidney disease, leukemia or problems that would require more than 6 weeks of venous access, may require the insertion of an implanted device. The venous access ports are surgically implanted in the chest and are accessed through the chest wall with a Huber needle.

The Huber needles are available in a variety of sizes to accommodate different patients. These Huber infusion sets are available from 19g x 3/4" size to 22g x 1" size. The needle set is latex free, so will not be a concern if a patient is admitted with a latex allergy. The fact they have a new needle hub and a wing design, offers greater security and accuracy when accessing the venous port site with the Huber needle. The set has an 11" micro bore tubing with a Y site, for when the patient is connected to infusions. This makes it more convenient for the patient and the nurses. These Huber needles come 25/box.

Always follow the protocol of the facility when using the implanted central port. Aseptic technique should always be used when caring for or accessing the venous port. The port should only be accessed by a registered nurse or physician. A Huber needle can be left in place for as long as 7 days after insertion, if there are no complications.

Prior to accessing the port with the Huber needle, always wash your hands with antibacterial soap and put on sterile medical gloves. Palpate the patient's chest in order to locate the needle port. Usually you can easily feel the port under the skin. Approximately the size of a quarter, the port will feel firm around the edges with a soft spongy center. After locating the port, follow the protocol of the facility, prepare a clean work area, prepare the Huber needle, clean the port site, insert the Huber needle and secure and cover the needle and site. Always document the gauge and length of the Huber needle used for access in the medical record.

One of the biggest benefits is that the implanted venous port allows for long term access and has the lowest incidence of blood borne infections. Although the port may have been inserted for the patient to receive chemotherapy, it can also be used for other things, such as antibiotics or blood. After use of the port is completed, remove the Huber needle per protocol. Again, always use sterile technique, flush the port per protocol, before you remove the needle.

The complications of the implanted port can include infiltration, skin breakdown, infection, occlusions, thrombus formation or catheter fracture. After assessing the port site, notify the physician and do not access the port if the site is red, tender, swelled or warm to touch.

The Huber needle is the only needle that is used to access the implanted venous port. Always check the site per facility protocol as long as the site is accessed with the Huber needle. Always use sterile technique when accessing or discontinuing a Huber needle, this cannot be stressed enough. The central venous implanted port allows the patient more freedom with daily life and is easy to maintain for hospital or home therapy.