Questions About PD
We thank you for your interesting question. There are three main points we would like to make here regarding safety for PD nurses when collecting samples of PD effluent. First, standard precautions are used today for all patient care in order to protect healthcare providers from infection and to prevent the spread of infection from patient to patient (1). Second, added to this, is the concern that all occupational exposure to blood or other potentially infectious materials (OPIM) places healthcare workers at risk for infection. The U.S Occupational Safety and Health Administration (OSHA) includes peritoneal fluid as one of the several types of human body fluids considered potentially infectious (2). Then third, over the past two decades, there has been a major movement to decrease the number of needlestick injuries in health care workers. To this end, many needleless devices and safer needle devices have been introduced and the field continues to rapidly evolve (3).
From a small convenience sample survey of members of the ISPD Nursing Liaison Committee from several different countries, while it is still common practice in some countries to use a needle and syringe to transfer the PD effluent from the PD Bag to blood culture bottles or sterile container, certainly in the United States and Canada there is definitely a movement to using needleless devices and safer needle devices to transfer PD fluid. We would recommend that you check with your local hospital and your dialysis provider to see if there are needleless devices and/or safer needle devices, including blunt needles and vacutainer connector transfer devices, you could use in your PD unit to minimize the risk for needle-stick injury for PD nurses while collecting samples of PD fluid effluent.
1. Centers for Disease Control and Prevention. Standard Precautions for All Patient Care (updated January 2016). Available at https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html
2. United States Department of Labor: Occupational Safety and Health Administration. Bloodborne Pathogens and Needlestick Prevention: Available at: https://www.osha.gov/bloodborne-pathogens/hazards
3. Centers for Disease Control and Prevention: The National Institute for Occupational Safety and Health (NIOSH). Preventing Needlestick Injuries in Health Care Settings (last reviewed June 2014). Available at https://www.cdc.gov/niosh/docs/2000-108/