Background

FAQs regarding Safe Practices for Medical Injections

A Patient Safety Threat Syringe Reuse

Preventing Unsafe Injection Practices

CDC Clinical Reminder: Spinal Injection Procedures

U.S. Outbreaks Associated with Drug Diversion by Healthcare Providers, 1983-2013

Infection Prevention during Blood Glucose Monitoring and Insulin Administration

FAQs regarding Assisted Blood Glucose Monitoring and Insulin Administration

CDC Clinical Reminder: Use of Fingerstick Devices

Infection Control Assessment of Ambulatory Surgical Centers

Insurance Stakeholders Meeting December 2011

Ambulatory Surgical Centers October 2010

Sticking with Safety May 2010

Injection Safety Stakeholder Meeting December 2009

Developing Documents for a Patient Notification

Planning Media and Communication Strategies

Planning the Release of Media and Patient Notification Letters

Conducting a Successful Press Conference or Media Opportunity

Establishing Communication Resources

Best Practices in Conduting Patient Notifications

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Injection safety, or safe injection practices, is a set of measures taken to perform injections in an optimally safe manner for patients, healthcare personnel, and others.

The Standard Precautions section of the2007 Guideline for Isolation Precautions [PDF 3.80]provides evidence-based recommendations for safe injection practices and reflects the minimum standards that healthcare personnel should follow to prevent transmission of infections in healthcare settings.

Despite these recommendations, outbreaks and patient notifications resulting from healthcare personnel failing to adhere to Standard Precautions and basic infection control practices continue to be reported.Unsafe injection practicesthat have resulted in disease transmission have most commonly included:

Using the same syringe to administer medication to more than one patient, even if the needle was changed or the injection was administered through an intervening length of intravenous (IV) tubing [12];

Accessing a medication vial or bag with a syringe that has already been used to administer medication to a patient, then reusing contents from that vial or bag for another patient [36];

Using medications packaged as single-dose or single-use for more than one patient [79];

Failing to use aseptic technique when preparing and administering injections [1012].

For these reasons, CDC reminds healthcare personnel of the following practices that are critical for patient safety:

administer medications from the same syringe to more than one patient, even if the needle is changed or you are injecting through an intervening length of IV tubing.

enter a medication vial, bag, or bottle with a used syringe or needle.

use medications packaged as single-dose or single-use for more than one patient. This includes ampoules, bags, and bottles of intravenous solutions.

use aseptic technique when preparing and administering injections.

The following FAQs summarize inquiries received by CDC from healthcare personnel regarding safe use of needles, syringes, and injectable medications in patient care settings. Wherever possible we have attempted to provide examples of outbreaks or patient notification incidents that support the guidance offered in these FAQs. An extensive reference list is included at the end of this document.

These FAQs are not intended as a comprehensive resource for all safe injection practices and additional considerations may be necessary for certain clinical scenarios or settings. Healthcare personnel are encouraged to consult the Standard Precautions section of the2007 Guideline for Isolation Precautions [PDF 3.80]to ensure that their practices adhere to the basic principles of infection control and aseptic technique. Additional information applicable to specific clinical settings or procedures may be available from professional organizations.

While the use of aseptic technique when preparing and administering injectable medications is applicable to all healthcare settings, including pharmacy areas, these FAQs are not intended to reflect the standards and recommended practices for handling medication vials and related products in pharmacy settingsthese should be determined in accordance with the state boards of pharmacy, the United States Pharmacopeia (USP), the Drug Enforcement Agency (DEA), and the Food and Drug Administration (FDA).

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National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)