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 the primary reason for non-use. In all, 71 (48%) and 60 (48%) respondents reported recent contaminated NSIs in 2012 and 2006, respectively. The majority were related to a needle on a disposable syringe. DISCUSSION: Despite only moderate perceived utility, SEIC uptake among CPAs is high. However, NSIs remain common. Several opportunities to reduce the risk for work-related BBP transmission among CPAs were evident.