Medication Administration Questions

No. Once they are used, the syringe and needle are both contaminated and must be discarded. Use a new sterile syringe and needle for each patient.

No. A small amount of blood can flow into the needle and syringe even when only positive pressure is applied outward. The syringe and needle are both contaminated and must be discarded.

No. Everything from the medication bag to the patient’s catheter is a single interconnected unit. All of the components are directly or indirectly exposed to the patient’s blood and cannot be used for another patient. A syringe that intersects through ports in the IV tubing or bags also becomes contaminated and cannot be used for another patient. Separation from the patient’s IV by distance, gravity and/or positive infusion pressure does not ensure that small amounts of blood are not present in these items.

The safest practice is to always enter a medication vial with a sterile needle and sterile syringe, even when obtaining additional doses of medication for the same patient. This adds an extra layer of safety in case, for some reason, the medication vial is not discarded at the end of the procedure as it should be and is inadvertently used on a subsequent patient.

There have been multiple outbreaks resulting from healthcare personnel reusing syringes to access medications for a single patient and then using contents from that vial or bag for subsequent patients [3–4]. In some of these outbreaks, healthcare personnel believed that they were being careful and their intention was to discard the vial or bag at the end of the procedure; however, this did not always occur and contents from the vial or bag were inadvertently used for subsequent patients [5].

The safest practice is for a syringe and needle to be used only once to administer a medication to a single patient, after which the syringe and needle should be discarded. This practice prevents inadvertent reuse of the syringe and protects healthcare personnel from harms such as needlestick injuries.

However, when this is not feasible (e.g., when administration of incremental doses to a single patient from the same syringe is an integral part of the procedure), reuse of the same syringe and needle for the same patient should occur as part of a single procedure with strict adherence to aseptic technique. In such situations it is essential that the syringe never be left unattended and that it be discarded immediately at the end of the procedure.

There have been situations of disease transmission and recent patient notification events in the setting of unintentional syringe reuse after a syringe was not immediately discarded following use on a patient [2,15].

Yes. The National Institute for Occupational Safety and Health (NIOSH) maintains a list of antineoplastic and other hazardous drugs in healthcare settings.  As part of this list, they provide guidance on the personal protective equipment and engineering controls necessary for working with hazardous drugs in healthcare settings.