Background: Recently, multiple regulations and recommendations for safe infection control practices
and safe injection and medication vial utilization have been implemented. These include single dose
and multi-dose vials for a single patient and regulations. It is a well known fact that transmission
of bloodborne pathogens during health care procedures continues to occur because of the use
of unsafe and improper injection, infusion, and medication administration. Multiple case reports
have been published illustrating the occurrence of infections in interventional pain management
and other minor techniques because of lack of safe injection practices, and noncompliance with
other precautions. However, there are no studies or case reports illustrating the transmission of
infection due to the use of single dose vials in multiple patients when appropriate precautions are
observed. Similarly, the preparation standards for simple procedures such as medial branch blocks or
transforaminal epidurals have not been proven to be essential. Further, the effectiveness or necessity
of surgical face masks and hats, etc., for interventional techniques has not been proven.
Objective: To assess the rates of infection in patients undergoing interventional techniques.
Study Design: A prospective, non-randomized study of patients undergoing interventional
techniques from May 2008 to December 2009.
Study Setting: An interventional pain management practice, a specialty referral center, a private
practice setting in the United States.
Methods: All patients presenting for interventional techniques from May 2008 to December 2009
are included with documentation of various complications related to interventional techniques
including infection.
Results: May 2008 to December 2009 a total of 3,179 patients underwent 12,000 encounters
with 18,472 procedures.
A total of 12 patients reported suspicion of infection. All of them were evaluated by a physician
and only one of them was a superficial infection due to the patient’s poor hygienic practices which
required no antibiotic therapy.
Limitations: Limitations include the nonrandomized observational nature of the study.
Conclusion: There were no infections of any significance noted in approximately 3,200 patients
with over 18,000 procedures performed during a 20 month period in an ambulatory surgery center
utilizing simple precautions for clean procedures with the use of single dose vials for multiple
patients and using safe injection practices.
Clinical Trial Registrion: NCT00625248
Key words: Interventional pain management, interventional techniques, complications, infection,
safe injection practices, single dose vials, multi-dose vials, surgical face masks, relative risk.
Gamifying the Infection Control Curriculum: The Impact on Nursing Students’ Knowledge, Exam Performance, and Course Perception
