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Learn how to use devices that help prevent needle-stick injury during catheter insertion.
WITH STRICTER ENFORCEMENT of the Bloodborne Pathogen Standard, you may be asked to evaluate devices engineered to protect against needle-stick injuries during intravenous (I.V.) catheter insertion. (See Exposure Safety, "Safer Needles: Not Optional," in the October issue of Nursing2002.) In this photo guide, we'll show you how to activate the safety mechanisms on two such devices. Before using any new product, attend an educational session with the manufacturer's representative to learn the proper technique. Then follow the steps in What To Do Before and After Inserting an I.V. Catheter to initiate I.V. therapy.
* Wash your hands. Assemble the tourniquet, insertion device, I.V. solution, alcohol swabs, tape, clean gloves, and sterile dressing.
* Identify the patient and describe the procedure. Ask if he has any allergies or if there's any reason you shouldn't use a specific arm for venipuncture.
* Place him in a comfortable position with his arm extended on a flat surface. Apply the tourniquet, choose an appropriate insertion site, and clean it according to your facility's guidelines. Avoid excessive tourniquet time.
* Put on clean gloves. Follow standard precautions to prevent contact with blood while inserting the I.V. device.
* Even if you can't get venous access, activate the I.V. safety mechanism before removing the needle from your patient's skin.
* Using standard precautions, clean the skin, if necessary, to remove blood.
* Follow facility guidelines to apply a sterile dressing to the insertion site. Write the date, time, catheter gauge and length, and your initials on the I.V. label; affix it to the dressing.
* Dispose of the needle device in a puncture-resistant sharps container and wash your hands.
* Document the location of the insertion site, the device brand name, catheter gauge and length, date and time, number of insertion attempts, any complications and treatments provided, the patient's response, and your name.
A list of manufacturers of these and other needle-stick safety devices is available on the Web at http://www.nursing2002.com under "Journal contents," November 2002.
Hanrahan, A., and Reutter, L.: "A Critical Review of the Literature on Sharps Injuries: Epidemiology, Management of Exposures and Prevention," Journal of Advanced Nursing. 25(1):144-154, January 1997.
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