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The use of metal or plastic needles in continuous subcutaneous infusion in a hospice setting

St. Clare Hospice, Hastingwood, Essex, United Kingdom

Margaret Yeldham, RGN

St. Clare Hospice, Hastingwood, Essex, United Kingdom

Suzanne Bell, RGN

Hastingwood, Essex, United Kingdom

Objectives. Battery-driven portable syringe drivers are a convenient method for administering many drugs by continuous subcutaneous infusion (CSCI) to patients who cannot swallow medications. At the St. Clare Hospice, nurses usually use plastic needles to minimize needlestick injury but sometimes have patients transferred to metal needles. This study retrospectively examines this practice and its effectiveness.

Methods. The duration of audit was four months. During this period, there were 40 patients (23 women, 17 men), who required their medications delivered by CSCI. A total number of 74 sites were used. Metal or plastic needle CSCIs connected with one-hour release Graseby^® Syringe Drivers were used. The syringes were set to deliver 2 mm/hour. The maximum volume syringe used was 50 ml. The data were collected retrospectively.

Analysis and results. Sixteen patients (21.6 percent) developed minor complications (13 plastic, three metal). Among them, 16 showed inflammation. Two patients (3.5 percent) showed slight bleeding. Only one patient (1.7 percent) showed local infection (metal). In 14 patients (18.9 percent), the needle was reinserted due to various reasons, including needles pulled out by patients or needles falling out due to unknown reasons. There were no needlestick injuries reported, and the staff members reported that all problems encountered were easy to identify and resolve.

Conclusion. Plastic needle CSCI prevents needlestick injury and gives minimum distress to the patients. More research is needed to determine the local side effects of drugs used and the strategies to resolve these problems.

Key Words: plastic needles • syringe driver • continuous subcutaneous infusion • hospice

American Journal of Hospice and Palliative Medicine®, Vol. 22, No. 2, 134-138 (2005)
DOI: 10.1177/104990910502200211


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