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Liquid release as a source of potential drug exposure during the handling of intravenous infusions in nursing

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Abstract

Purpose

This study aims at experimentally determining the incidence and extent of liquid releases onto the operator’s hands and into the work environment during common nursing operations involving infusions.

Methods

A sequence of operations related to the preparation and administration of infusions was conducted by three subjects for 15 times each using fluorescein marked infusion solutions and two different infusion sets (standard set vs. safety-optimized set). Unintended release of liquid was quantified by glove and surface wipe sampling and HPLC/FD analysis of the samples. Operations concerning the disposal of infusions were also part of the study.

Results

In over 90% of the simulations, a release of infusion solution was observed in a standard workflow, comprising priming and decapping the infusion set, connecting it to a peripheral intravenous (IV) cannula, and detaching it again. Based on median values (229 vs. 26 μl), the release of infusion solution was about ninefold higher when using the non-optimized standard infusion set. During decapping, a hand contamination was found in a majority of cases.

Conclusions

The handling of infusions may involve a risk of nurses’ exposure to active agents by release of infusion solution into the work environment. According to our results with different infusion sets, exposure risks can be reduced technically and by appropriate handling. Nevertheless, hand contaminations found for both sets emphasize the necessity for additional measures such as more consistent use of protective gloves.

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Acknowledgements

The authors thank Marie-Luise Kimbel for language revision of the manuscript. This study was funded by the German Social Accident Insurance Institution for the Health and Welfare Services (BGW).

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Authors and Affiliations

  1. Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 67, 55131, Mainz, Germany

    Verena Segner, Renate Kimbel, Philipp Jochems, Stephan Letzel & Bernd Roßbach

  2. German Social Accident Insurance Institution for the Health and Welfare Services (BGW), Cologne, Germany

    André Heinemann

  3. Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany

    Daniel Wollschläger

Authors
  1. Verena Segner
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  2. Renate Kimbel
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  3. Philipp Jochems
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  4. André Heinemann
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  5. Stephan Letzel
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  6. Daniel Wollschläger
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  7. Bernd Roßbach
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Corresponding author

Correspondence to Renate Kimbel.

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The authors declare that they have no conflict of interest.

Additional information

This manuscript contains data of the doctoral thesis in preparation of V. Segner.

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Segner, V., Kimbel, R., Jochems, P. et al. Liquid release as a source of potential drug exposure during the handling of intravenous infusions in nursing. Int Arch Occup Environ Health 90, 275–284 (2017). https://doi.org/10.1007/s00420-017-1196-0

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  • DOI: https://doi.org/10.1007/s00420-017-1196-0

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