Safety-engineered intravenous catheter utilization among Canadian pediatric anesthesiologists

Abstract

Introduction Compared with other specialties, anesthesiologists are at increased risk of acquiring a blood-borne pathogen (BBP) through needle-stick injuries (NSIs). Safety-engineered intravenous catheters (SEICs) have been designed to reduce NSIs but have not been well received. Our objective was to determine SEIC usage by pediatric anesthesiologists, including availability, utilization, perceived utility, and sources of NSI before and after legislation mandating their use in Canada.Methods After Ethics Committee approval, we conducted two electronic surveys of Canadian pediatric anesthesiologists (CPAs) based in tertiary care settings. Survey responses from May through August 2012 and June through September 2006 were considered. In addition to SEIC use and perceived utility, respondents described factors influencing SEIC adoption and workplace NSIs. Standard metrics of survey validity and reliability were employed. Results Completed questionnaires were returned by 154 (69%) and 124 (53%) respondents in 2012 and 2006, respectively, representing 15 of 16 Canadian pediatric tertiary care centres. Reported SEIC availability increased in hospitals (82% vs 98%; difference in proportion 16%, 95% confidence interval [CI]: 9 to 24%; P \ 0.001) and in operating rooms (62% vs 86%; difference in proportion 24%, 95% CI: 13 to 34%; P \ 0.001) Respondents' report of ''routine'' personal use of SEICs increased from 43 of 76 (56%) to 112 of 132 (85%) (difference in proportion 29%, 95% CI: 16 to 41%; P \ 0.001). Attitudes concerning perceived utility of SEICs remained unchanged and evenly split between respondents. ''Awkward handling'' remained Discussion En dépit d'une utilité perçue qui n'est que modérée, l'adoption des CIVS est élevée parmi les anesthésiologistes pédiatriques canadiens. Les piqûres d'aiguille restent néanmoins fréquentes. Plusieurs possibilités de réduction du risque de transmission des BBP au travail parmi les anesthésiologistes pédiatriques canadiens ont été évidentes.

Engineering solutions for safety: not always as simple as they seem

“…I am grateful to the Editor-in-Chief of the Journal for asking me to give an unashamedly British perspective on the paper by Murto et al (this issue) about the use of safety-engineered intravenous catheters (SEICs) in pediatrics. 1 Several aspects of this study stand out for discussion -study design, engineering solutions for safety, challenges in pediatrics, and needlestick injuries (NSI).…”

“…Despite the initial appeal of applying ''simple'' engineering solutions to safety issues in anesthesia, things are never as straightforward as they appear. Human factors, 1 Plusieurs aspects de cette étude sont sujettes à débat: le plan de l'étude, la conception de solutions pour la sûreté, les défis en pédiatrie et les lésions provoquées par les aiguilles.…”