Engineering changes present a more promising avenue. Although some hospitals in Canada have already implemented needleless intravenous-tube connector systems, the risk of becoming infected from tubing upstream from patients is small compared with the risk posed by needles directly contaminated with blood. Concentrating on phlebotomy and suture needles makes sense. Both blunt suture needles and phlebotomy needles with safety devices are available in Canada. Our very limited discussions with manufacturers and local surgeons indicate that they are not widely used.
Cost is an issue.
No doubt some of this difference in cost derives from lower demand. The CDC studies provide an initial glimpse of interesting approaches, but many issues remain unresolved. There will be few answers to these questions if we do not start using these devices more widely and evaluating their success in reducing injuries in a variety of clinical settings. The systematic prevention of any injury requires a combination of interventions aimed at all stages of the event. Nevertheless, primary prevention by such means as vaccination and engineering changes hold the most promise for reducing the risk of infection from percutaneous injury.