Safe Injection Practices

Between 2000 and 2004, four large outbreaks of hepatitis B and hepatitis C viral infections among patients in ambulatory care facilities were attributed to either the reinsertion of used needles into multi-dose vials or solution containers; or the use of a single needle/syringe to administer intravenous medications to multiple patients.1 These unsafe injection practices indicate that some HCP are unaware of, do not understand, or do not adhere to basic principles of infection control and aseptic techniques.

Safe injection practices in oral healthcare settings include the use of sterile, single-use, disposable needles/syringes for each patient; the use of single-dose vials of therapeutic agents; and administering local anesthetics from a cartridge to a single patient. To ensure that all HCP understand and adhere to recommended practices, principles of infection control and aseptic techniques must be reinforced in training programs and incorporated into institutional policies (Box B).1,3

Box B. Aseptic Technique Practices for Parenteral Medications.1,3
  • All medications, weather in single-dose cartridges, ampules, vials, prefilled syringes, or multi-dose vials should be handled with aseptic techniques to prevent contamination.
  • Single-dose cartridges, ampules, vials, or prefilled syringes should be used for parenteral medications whenever possible.
  • The leftover contents of single-dose cartridges, ampules, vials, or prefilled syringes should be discarded; and never combined with medications for use on another patient.
  • Medications from single-dose cartridges, ampules, vials, or prefilled syringes should not be administered to multiple patients, even if the needle is changed.
  • If necessary to use a multi-dose vial, its access diaphragm should be cleansed with 70% alcohol before inserting a sterile device into the vial.
  • A multi-dose vial should be discarded if sterility is compromised.
  • Always use a sterile, single-use, disposable needle and/or syringe for each patient.
  • All fluid infusion and administration sets (e.g., IV bags, tubing, and connections) are single-patient use items and must not be used on multiple patients.
  • Aseptic technique should be used when preparing IV infusion and administration sets, and entry into or breaks in the tubing should be minimized.