Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures--Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995.

Health-care workers (HCWs) are at risk for infections with bloodborne pathogens resulting from occupational exposures to blood through percutaneous injuries (PIs). Phlebotomy, one of the most commonly performed medical procedures, has been associated with 13% - 62% of injuries reported to hospital occupational health services and 20 (39%) of the 51 documented episodes of occupationally acquired human immunodeficiency virus (HIV) infection reported in the United States (CDC, unpublished data, 1996). Although safety devices designed to prevent PIs associated with phlebotomy have been available for use in the United States, clinical evaluation of these devices has been difficult because 1) ascertainment of PIs is difficult (many injuries are unreported, and observation of all procedures is impractical because phlebotomy is performed throughout the hospital by different groups of HCWs at all hours), 2) data to calculate PI rates (i.e., the number of phlebotomies performed and devices used) are not routinely available, 3) a large number of phlebotomies must be evaluated because of the low rates of phlebotomy-related PI and 4) rates of safety-feature activation are difficult to assess. This report summarizes a collaborative study by CDC and six hospitals to evaluate safety devices for phlebotomy. The findings indicate that use of safety devices significantly reduced phlebotomy-related PI rates while having minimal clinically apparent adverse effects on patient care.