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Medication injection safety knowledge and practices among anesthesiologists: New York State, 2011
Prabhu Gounder1, Richard Beers, Katherine Bornschlegel
1Scientific Educational and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY 11101, USA.
Study Objective:
To survey anesthesiologists to assess medication injection safety knowledge and practices, and to improve infection control programs of the New York City Department of Health and Mental Hygiene and the New York State Society of Anesthesiologists (NYSSA).
Design:
Survey instrument.
Setting:
Scientific Educational and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Measurements:
A confidential, 23-question survey was emailed to a total of 2,310 NYSSA members. Data from the survey were culled from the responses of NYSSA members who practiced in New York State only.
Main Results:
Of the 607 survey respondents, 595 met inclusion criteria (response rate 26%). Of these, 94% to 99% correctly answered 4 categories of questions about injection-contamination mechanisms. Respondents reported unacceptable practices (eg, not using a new needle and syringe for each new patient [3%]; not using a new needle and syringe to access medication vials [28%]; and combining vial content leftovers [11%]). Resident physicians reported these unacceptable practices more often than attending physicians. Use of medication vials for multiple patients (permitted for multi-dose vials but a potentially high-risk practice) was reported by 49% of respondents and was more common among those who worked in outpatient settings. Reported barriers to using a new medication vial for each new patient were medication shortages (44%), reduction of waste (44%), and cost (27%). Unacceptable or potentially high-risk practices were more common among respondents who reported ≥ one barrier.
Conclusions:
Although they were not necessarily representative of all anesthesiologists in New York State, unacceptable or high-risk injection practices were common among respondents despite widespread knowledge regarding injection-contamination mechanisms. System barriers contribute to the use of medication vials for multiple patients.
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