Glass Particle Contamination and Using the Filter Needle: A Cross-sectional Study

Abstract

ABSTRACT: Purpose: To identify the levels of knowledge of nurses and physicians about the contamination of micro-sized glass particles in medicine content when opening glass ampoules containing parenteral medicines and the use of filter needles in reducing contamination. When the medicine ampoule is broken and opened, spill into the ampoule and contaminates the medicine. Medicines contaminated with glass particles pose a potential danger when they are administered parenterally to patients. Material and Methods: This study was planned as a descriptive cross-sectional study. The study was conducted with a total of 600 healthcare professionals, 300 physicians and 300 nurses, working in a university hospital between October and November 2020. The data were collected using the “Personal Information Form” and the “Information Form about Glass Particle Contamination and Filter Needle Use”. Results: The highest response to the question "medicine contaminated with glass particles can cause complications in the patient" was I do not know at 52.7%. The highest number of correct answers at the rate of 76% was given to the question "particle scattering to buffer/fingers at glass ampoule opening”. When nurses were asked "presence of micro-sized glass particles in the medicine drawn from the ampoule to the syringe" and "preventing from giving glass particles with the medicine to the patient", the rate of correct answers was higher with significant differences compared to physicians. Conclusion: Healthcare professionals had moderate knowledge of glass particle contamination and the use of filter needles. Variables such as profession, number of ampoules used in the clinic, and educational status affect the level of knowledge. Findings inform to stresses the need to raise awareness for reducing glass particle contamination. Keywords: Contamination, Filter needle, Glass particle, Healthcare professionals

Keywords

• Contamination
• Filter needle
• Glass particle
• Healthcare professionals

References

1. American Society of Health-System Pharmacists (2014). ASHP Guidelines on Compounding Sterile Preparations. American Journal of Health-System Pharmacy, 71, 145-166. Retrieved 18 October, 2023, from https://www.ashp.org//media/assets/policyguidelines/docs/guidelines/compounding-sterile-preparations.ashx
2. Bukofzer, S., Ayres, J., Chavez, A., Devera, M., Miller, J., Ross, D., Shabushnig, J., Vargo, S., Watson, H., & Watson, R. (2015). Industry perspective on the medical risk of visible particles in injectable medicine products. PDA Journal of Pharmaceutical Science and Technology, 69(1), 123–139. https://doi.org/10.5731/pdajpst.2015.01037
3. Carbone-Traber, K. B., & Shanks, C. A. (1986). Glass particle contamination in single dose ampules. Anesthesia and Analgesia, 65, 1361–1363.
4. Carraretto, A. R., Curi, E. F., Almeida, C. E. D., & Abatti, R. E. M. (2011). Glass ampoules: Risks and benefits. Revista Brasileira De Anestesiol, 61(4), 513–521. https://doi.org/10.1016/S0034-7094(11)70059-9
5. Cassista, J., Payne-Gagnon, J., Martel, B., & Gagnon, M. P. (2014). Applying theory to understand and modify nurse intention to adhere to recommendations regarding the use of filter needles: an intervention mapping approach. Nursing Research and Practice, 2014, 1-8. https://doi.org/10.1155/2014/356153
6. Erkoc Hut, A., & Bayir, Y. (2017). The danger in glass medicine ampoules; Splınter-form glass partıcles. Gumushane University Journal of Health Sciences, 6 (3), 105-110.
7. Erkoc Hut, A., & Yazici, Z. A. (2021). Glass particle contamination threat in nursing practice: A pilot study. Journal of Advanced Nursing, 77(7), 3189-3191. https://doi.org/10.1111/jan.14847
8. Erkoc, A. , Tan, M., Yurugen, B. , Omaz, S. & Yazmaci, D. (2015). The frequency of injuries among nurses while breaking medicine ampoules and opinions related ampoule crushers . Gumushane University Journal of Health Sciences, 4 (3) , 412-420 .

9. Harmon, D. L. (2014) Anesthesia safety: filter needle use with glass ampules". UNF Graduate Theses and Dissertations, 538, 1-53.
10. Heiss-Harris, G. M., & Verklan, M.T. (2005) Maximizing patient safety: filter needle use with glass ampules. The Journal of Perinatal & Neonatal Nursing, 19(1), 74-81. https://doi.org/10.1097/00005237-200501000-00015
11. Infusion Nurses Society (2016). Infusion therapy standards of practice. Journal of Infusion Nursing, 39(1), 70. Jack, T., Brent, B. E., Boehne, M., Müller, M., Sewald, K., Braun, A., Wessel, A., & Sasse, M. (2010). Analysis of particulate contaminations of infusion solutions in a pediatric intensive care unit. Intensive Care Medicine, 36(4), 707–711. https://doi.org/10.1007/s00134-010-1775-y
12. Joo, G. E., Sohng, K. Y., & Park, M. Y. (2016). The effect of different methods of intravenous injection on glass particle contamination from ampules. SpringerPlus, 5, 1–8. https://doi.org/10.1186/s40064-015-1632-0
13. Kawasaki Y. (2009). Study on insoluble microparticulate contamination at ampoule opening. Journal of the Pharmaceutical Society of Japan, 129(9), 1041–1047. https://doi.org/10.1248/yakushi.129.1041
14. Langille S. E. (2013). Particulate matter in injectable medicine products. PDA Journal of Pharmaceutical Science and Technology, 67(3), 186–200. https://doi.org/10.5731/pdajpst.2013.00922
15. Lee, K. R., Chae, Y. J., Cho, S. E., & Chung, S. J. (2011). A strategy for reducing particulate contamination on opening glass ampoules and development of evaluation methods for its application. Medicine Development and Industrial Pharmacy, 37(12), 1394–1401. https://doi.org/10.3109/03639045.2011.580349
16. Lye, S. T., & Hwang, N. C. (2003). Glass particle contamination: is it here to stay?. Anaesthesia, 58(1), 93-94. https://doi.org/10.1046/j.1365-2044.2003.296812.x
17. Official Newspaper of the Republic of Turkey. Resmi Gazete. Regulation Amending the Nursing Regulation. Number 27910; 2011, 19 April. Retrieved 16 October, 2023, from https://www.resmigazete.gov.tr/eskiler/2011/04/20110419-5.htm
18. Preston, S. T., & Hegadoren, K. (2004). Glass contamination in parenterally administered medication. Journal of Advanced Nursing, 48(3), 266–270. https://doi.org/10.1111/j.1365-2648.2004.03195.x
19. Puntis, J. W., Wilkins, K. M., Ball, P. A., Rushton, D. I., & Booth, I. W. (1992). Hazards of parenteral treatment: do particles count?. Archives of disease in childhood, 67(12), 1475–1477. https://doi.org/10.1136/adc.67.12.1475
20. Sabon, R. L., Cheng, E. Y., Stommel, K. A., & Hennen, C. R. (1989). Glass particle contamination: Influence of aspiration methods and ampule types. Anesthesiology, 70, 859–862.
21. Sogut, N. N. & Erkoc Hut, A. (2022). The hidden threat in parenteral drugs: Glass particle contamination. Gumushane University Journal of Health Sciences, 11 (3), 1265-1273. https://doi.org/10.37989/gumussagbil.1003849
22. Timmons, C. L., Liu, C. Y., & Merkle, S. (2017). Particulate Generation Mechanisms during Bulk Filling and Mitigation via New Glass Vial. PDA journal of pharmaceutical science and technology, 71(5), 379–392. https://doi.org/10.5731/pdajpst.2017.007724
23. Turco, S. J., & Davis, N. M. (1971). Detrimental effects of particulate matter on the pulmonary circulation. JAMA, 217, 81-82. https://doi.org/10.1001/jama.1971.03190010063029
24. Yorioka, K., Oie, S., & Kamiya, A. (2009). Comparison of particulate contamination in glass and plastic ampoules of glycyrrhizin injections after ampoule cutting. Journal of Food and Medicine Analysis, 17, 225-228. https://doi.org/10.38212/2224-6614.2606
25. Zabir, A. F., Choy, C. Y., & Rushdan, R. (2008). Glass particle contamination of parenteral preparations of intravenous medications in anesthetic practice. South African Journal of Anesthesia and Analgesia, 14(3), 17–19. https://doi.org/10.1080/22201173.2008.10872550