‘Active’ and ‘Passive’ devices is wrong terminology

“Passive vs Active” conjures up “Black and White” – but other colours work well too!

A 7-colour spectrum of terms won’t work but “Active”, “Semiautomatic” and “Automatic” will.

In my recent paper on frequency of use of sharps engineered devices (SED) I deliberated over “passive” and “active” to describe SED mechanisms. Something didn’t gel. The SED in Doris Dicristina’s recent study significantly reduced wingset sharp injuries – but it was neither “passive” nor “active” – because you need push a button.
Then I incredulously learnt of a hospital who were staying with a troublesome active wingset device because “no passive wingsets had been developed” – yet semi-automatic wingset SED proven to reduce SI were available. Then I knew what didn’t gel – our terminology is wrong – it restricts the use of effective technology.

After an hour discussing the issue with a learned colleague we agreed we should be using the three terms proposed by Tosini et al in their large SED study – “Active”, “Semiautomatic” and “Automatic”.

True, they found automatic best, but semiautomatic SED had fourfold less SI than active SED!

We need delete “passive” from our SED vocabulary. More HCW will sustain SI if we keep it.

Your comments are welcome.

Passive vs Active devices is wrong terminology

“Passive vs Active” conjures up “Black and White” – but other colours work well too!

A 7-colour spectrum of terms won’t work but”Active”, “Semiautomatic” and “Automatic” will.

In my recent paper on frequency of use of sharps engineered devices (SED) I deliberated over “passive” and “active” to describe SED mechanisms. Something didn’t gel. The SED in Doris Dicristina’s recent study significantly reduced wingset sharp injuries – but it was neither “passive” nor “active” – because you need push a button.
Then I incredulously learnt of a hospital who were staying with a troublesome active wingset device because “no passive wingsets had been developed” – yet semi-automatic wingset SED proven to reduce SI were available. Then I knew what didn’t gel – our terminology is wrong – it restricts the use of effective technology.

After an hour discussing the issue with a learned colleague we agreed we should be using the three terms proposed by Tosini et al in their large SED study – “Active”, “Semi-automatic” and “Automatic”.

True, they found automatic best, but semiautomatic SED had fourfold less SI than active SED!

We need delete “passive” from our SED vocabulary. More HCW will sustain SI if we keep it.

Your comments are welcome.

Sharps safety devices – why is Australian use lower than USA?

Australian hospitals use less sharps safety devices than USA

Sharps injuries (SI) among Australian healthcare professionals (HCP) are three times that of USA.

The best way to reduce SI is to use safety engineered devices (SED). All Australian hospitals use SED – but to what extent?

To ascertain SED extent, you need to “dumpster dive” – you need look at sharps container contents. If Australian HCP are using less SED  it could be a contributing factor in the higher SI rate.

In my survey published online last week in Healthcare infection I examined the contents of 102 sharps containers from 27 hospitals in 5 Australian capital cities and found 30% of the 10,000 hollow-bore needles were SED.  A similar but smaller sampling in the U.S. revealed that 46% were SED.

The paper concludes a high proportion of Australian HCP are unnecessarily at risk of SI while handling sharps. Recommendations include more widespread SED evaluation and adoption (automatic and semi-automatic SED where feasible), repetitive competency training and safety-ownership. Legislation may be indicated.

Click here for access to Abstract and Author copy for this study

Too many sharps injuries from punctured containers – why?

“Finer needles, higher temps, and thinner walls, all make container penetration easier.”

500 healthcare professionals in USA and 200 in UK sustain sharps injuries (SI) from needles puncturing containers each year. Not high numbers but they CAN be markedly reduced with tougher sharps containers (and tougher Standards)?

In my recent paper, I researched this question by examining 3 parameters affecting needle penetration – needle gauge, temperature, and container wall thickness.

Under controlled standard conditions I conducted 288 tests comparing 6 needle gauges (21G – 30G), 3 temperatures (130C, 230C, 430C) and 3 wall thicknesses (1.9mm, 2.4mm, 2.8mm).

Would 30G penetrate more easily than 21G? Many say 21G …but the answer is 30G – by far. A 30G needle penetrates a wall at 1/3rd the force needed for 21G! At 430C it is 1/7th.

So… finer needles, higher temps, and thinner walls are why sharps injuries from container-penetration are occurring – ‘container abuse’ is rare.

46% of U.S. needles are finer than 21G (31% in UK) so it is surprising Standards still use 21G to test containers. And USA Standard F2132 still uses a low 12.5N as the Pass for “force necessary to penetrate”. However, Canada’s healthcare workers lobbied successfully to raise their Standard’s requirement for wall toughness to 20N – 60% higher than older Standards. Go Canada!

True, tougher containers cost more. So too do needle safety devices. If we pay more for safety devices, then we need pay more for safer, tougher containers. There’s always a cost for safety.

In our quest for zero Sharps Injuries, needles penetrating through sharps containers is one cause of injury we can readily eliminate.