Circulation 122,210 • Volume 32, No. 1 • June 2017   Issue PDF

Spotlight on Infection Prevention: Safe Injection Practices

Terri Lee Roberts, BSN, RN, CIC, FAPIC

Safe injection practices are part of Standard Precautions, providing for patient safety and health care provider protections. According to the Centers for Disease Control and Prevention (CDC), syringe reuse and misuse of medication vials over the past decade have resulted in dozens of infectious outbreaks and the need to alert more than 100,000 patients to seek testing for infection with hepatitis B virus, hepatitis C virus, and HIV. This harm is preventable!

For more information, please visit the CDC’s Injection Safety website:

The One & Only Campaign

The Centers for Disease Control and Prevention and the Safe Injection Practices Coalition lead the One & Only Campaign, a public health initiative to increase awareness of safe injection practices. Its goal is to eliminate infections resulting from unsafe injection practices. Remember “One Needle, One Syringe, Only One Time” for each and every injection! For example, use a new syringe and new needle when drawing up more propofol for an infusion. Never re-use tubing for infusions between patients, even if it is auxiliary tubing inserted upstream into the patients main i.v. line.

For more information, please visit the One and Only Campaign website.

Sharps Disposal Containers

Used sharps need to be disposed of immediately into a sharps container approved by the U.S. Food and Drug Administration (FDA). These containers have been evaluated for safety and effectiveness to help reduce the risk of injury and infections from sharps. FDA-cleared sharps disposal containers are made from puncture-resistant materials with leak-resistant sides and bottom and a tight fitting, puncture-resistant lid. These containers are labeled to warn of hazardous waste and marked with a line to indicate when the container is considered full. Close and properly dispose of the container when it is full.

For more information, please visit the CDC’s Stop Sticks Campaign website and the FDA’s Medical Devices website.

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Drug Diversion is a Patient Safety and Infection Prevention Event

According to the U.S. Department of Justice Drug Enforcement Agency (DEA), the abuse of controlled substances is a serious problem, and health care providers are as likely as anyone else to abuse drugs. Drug-impaired health care providers are a source of controlled-substances diversion. Health care providers have easy access to controlled substances and some will divert and abuse these drugs to self-medicate, relieve stress, or improve mental alertness and work performance.

If a health care provider tampers with injectable drugs, they must do so quickly to avoid detection. It is likely sterile technique is not used and the needle used to inject the drug is not replaced. If the health care provider is infected with hepatitis B virus, hepatitis C virus, and/or HIV, the exposed patients are at risk of developing infection.

Drug-diversion programs for health care facilities include

  • Policies to prevent, detect, and report drug diversion
  • Processes to observe and audit use of controlled substances
  • Immediate attention to suspicious audits
  • Collaborative relationships with public health and regulatory officials
  • Staff education on drug diversion

For more information, please visit the DEA Diversion Control Division website and the CDC’s Injection Safety website.

Terri Lee Roberts, BSN, RN, CIC, FAPIC, is an infection prevention analyst with the Pennsylvania Patient Safety Authority.

Disclosure: The author has no financial conflicts of interest to disclose for this article.

Additional Resources

Prevent the occurrence of bloodborne disease transmission associated with unsafe injection practices. Pa Patient Saf Advis [online] 2011 Jun. Retrieved from

Bradley S, Perz JF, & McKnight EV. (2014, October 14). Patient Safety Authority [Webinar]. Injection safety: what every ambulatory surgery facility physician and manager/owner needs to know. Retrieved from