Phlebotomists' safety practices. A College of American Pathologists Q-Probes study of 683 institutions

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.