Authors (including presenting author) :
Leung PM(1), Yiu WK(1), Chang KY(1), Lee WH(1), Chan YW(1), Lam MS(2), Wong CY(2), Leung HC(2), Lau MH(2), Chow MS(3), Leung WN(3), Au LH(3)
Affiliation :
(1) Nursing Service Division, Tuen Mun Hospital, (2) Nursing Service Division, Pok Oi Hospital & Tin Shui Wai Hospital, (3) Infection Control Unit, NTWC
Keyword 1: :
Needlestick Injuries
Keyword 2: :
Safety-engineered
Keyword 3: :
Occupational Safety
Keyword 4: :
Safety Culture
Keyword 5: :
Phlebotomy services
Introduction :
Needlestick injuries (NSIs) remain a major occupational hazard for healthcare workers (HCWs), with risks of exposure to bloodborne pathogens such as HBV, HCV, and HIV. In NTWC, NSI reports showed an increasing trend, especially during blood taking and blood culture collection in phlebotomy services. Traditional methods often used scalp vein needles without safety features or syringe-based venipuncture, requiring two needle changes for blood cultures (detaching the initial needle and attaching a transfer needle for bottle inoculation). These repeated manipulations during disassembly or recapping significantly raised NSI risk. To mitigate this, we introduced safety-engineered scalp vein needles: the BD Vacutainer® Push Button Blood Collection Set (one-handed in-vein push-button retraction) and JMS safety scalp vein needles (slide-lock shields, ergonomic color-coded wings, siliconized thin-walled cannulas for better flow and less hemolysis). These allow direct inoculation via tubing and luer adapters, eliminating needle changes. Used needles retract into the safety shield, reducing post-procedure exposure and NSI risk during disposal.
Objectives :
1. Reduce NSI incidence associated with scalp vein needle use in blood taking and blood culture collection by adopting safety-engineered devices among phlebotomists. 2. Integrate these devices into routine daily operations in both in-patient and out-patient settings. 3. Foster a strong safety culture in phlebotomy procedures.
Methodology :
The transition to safety-engineered devices was rolled out in structured phases. Phase 1: Initial adoption for general blood taking (excluding blood culture) Introduced BD Vacutainer® Push Button sets (with UltraTouch™ technology) and JMS safety scalp vein needles for routine phlebotomy in late 2024. Phase 2: Training & procurement (Nov 2024 – Apr 2025) Conducted vendor-led and senior phlebotomist training with hands-on sessions on device features, safety activation (push-button/slide-lock), avoidance of recapping, and safe disposal. Feedback collected via questionnaires to refine adoption. Phase 3a: Adoption in out-patient then in-patient settings (Apr–Jun 2025) Started in out-patient areas (simpler cases), then expanded to in-patient wards once stock was sufficient. Phase 3b: Evaluation for blood culture use (May 2025) Assessed devices for blood culture collection, focusing on direct inoculation via luer adapters to eliminate needle changes and improve workflow. Phase 4: Trial in blood culture practice (Jun–Nov 2025) Ordered dedicated stock for blood culture use; provided department-specific training and a training video (developed with infection control team). Feedback collected via questionnaires. Phase 5: Full adoption including blood culture (by Q1 2026) Incorporated safety devices into blood culture practice across NTWC acute hospitals, with refined audit forms and explanatory notes.
Result & Outcome :
Overall NSI incidence (excluding accidental cases) decreased from 9 in 2024 to 7 in 2026. No incidents involved disposal of used needles, indicating that safety-engineered devices effectively reduced this risk type and enhanced occupational safety. Phlebotomists were well trained, widely accepted the new devices as standard equipment, and a stronger NSI prevention safety culture was established.
