PP 1 - Level of standard venipuncture practices at Teaching Hospital Peradeniya

Udayarathna UDH¹, Sinthujan JS¹, Dissanayake DMKM¹, Yathusa R¹, Jayalath UANNP¹, Kudagammana HDWS² , ¹Faculty of Medicine, University of Peradeniya²Department of Microbiology, Faculty of Medicine, University of Peradeniya

Abstract

Introduction

Standard infection prevention protocols during venipuncture are essential to prevent infection and protect staff and patients.

Objectives

This study aimed to assess proper hand hygiene, use of gloves, adherence to aseptic non-touch technique, cleanliness of the venipuncture site, proper sharps handling and waste disposal.

Design, setting and methods

A descriptive cross-sectional study was done in all four surgical, all three medical, all two gynaecology and obstetrics, including pre- and postnatal wards, orthopaedic, toxicology, accident and emergency wards and the outpatient department of the Teaching Hospital, Peradeniya. Infection prevention practices related to venipunctures for routine blood testing and for blood culture sampling were evaluated, using two locally validated and pre-tested checklists based on WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy (2010) and the Hospital Infection Prevention and Control Manual (2021) of the Sri Lanka College of Microbiologists.

Results

A total of 427 venipuncture procedures (n=407 routine blood tests, n=20 blood cultures) were observed. On routine venipunctures, hand hygiene compliance both before and after the procedures was observed in 85 (21%) procedures. The risk of contamination due to reused gloves was seen in 134 (33%) procedures. Proper skin cleaning was achieved in 274 (67%) procedures. Across the procedures, adherence to aseptic non-touch technique was observed in 58 (14%) procedures. Sharps handling and disposal revealed risky practices in 89 (22%) of observations, while only in 100 (25%) observations were gloves correctly disposed of in infectious waste bins by the end of routine venipunctures.

Regarding blood culture collection practices, while 15 (75%) healthcare workers practised hand hygiene before skin preparation, 9 (45%) did not repeat it before sample collection. Although sterile gloves were used in 16 (80%) of blood culture procedures, the practice of aseptic non-touch techniques was not maintained in any event. Proper skin cleaning was achieved in only 6 (30%) of instances out of 20 events. Touching the sterile site after cleaning was seen in 7 (35%) of events, the rubber cap of the blood culture bottle was cleaned only in 6 (30%) of events, and sharps handling revealed risky practices in 2 (10%) blood culture collection events.

 Conclusions

Major deviations from infection control protocols were observed in both venipunctures for routine investigations and blood cultures.