Urgent request for info re: needleless flu clinics

[Lori Roehl]

In reading your email, all I can tell you is that our HMO here in
Seattle (Group Health) used a needleless system I believe 2 years ago.
We offered both traditional needle syringes and the Bioject needleless
system. After one year we decided not to use Bioject again, due
primarily to many complaints of increased pain during and after the
immunization. I worked a 4 hour flu shot clinic, and noticed complaints
particularly in elderly adults with little subcutaneous fat. I heard
from primary care staff that they received more than the usual phone
calls the following week, with complaints of large bruises after the
Bioject. Of course, there were also many people who said they liked the
Bioject better, and felt it was much less painless that the needle
system. (Staff using the Bioject did attend inservice training before
working the flu shot clinics.)
If you need any more information, I'd have to refer you to someone else
within the coop who works with either flu shots or injections...Hope the
anecdotal info was helpful...

Lori Roehl RN, MSN
Healthy Steps Specialist
Group Healthy Cooperative of Puget Sound
(206)729-6404


>>> saewyc at tc.umn.edu 12/13/00 09:40AM >>>

Colleagues,

I'm looking for information from public health agencies that are
either
required to use or have chosen to use needleless injection systems for
their large-scale flu immunization clinics. This past year we conducted
a
collaborative project with nursing students and pharmacy students to
provide flu clinics for dorm residents and health professions students
here
on our campus, and we're planning on doing the same again next year.

However, one of the issues that came up during our clinic was the
evidence
base for deltoid I.M injection techniques, with our clinical nursing
faculty teaching z-tracking and the pharmacy faculty (and, truth to
tell,
all the public health nurses I know in all the different agencies)
using
the "pinch" method, which plumps up the muscle for a straight
injection,
rather than moving subcutaneous tissue aside. We saw this as a perfect
opportunity to include a research study in next year's project, and
have
begun developing a proposal.

However, the recent passage of the Needlestick Safety and Prevention
Act
may change everything. I'm not at all familiar with the latest
needleless
or safety devices for deltoid IM injections, and I don't know if one
could
even do z-tracking with them, much less if there are differences in
vaccine
leakage, bleeding, or pain with the various devices. I'm also not sure
how
this new law will affect flu clinics around the country, especially in
the
rural public health agencies, but I know there are states like
California
that have had stringent needlestick protection laws under their state
OSHA
for a while.

Could anyone who uses needleless or needle-safety devices for their
large-scale immunization clinics email me privately and let me know
which
types of devices you use, how they work in your system, and whether
you're
seeing differences in people's responses to immunizations in this
manner?
I'd be especially interested in information about effectiveness related
to
pain, bleeding, or actual immune titers.


As we have some urgent deadlines for grant proposals, an immediate
reply
would be greatly appreciated.

Regards,

Elizabeth Saewyc

--
Elizabeth M. Saewyc, PhD, RN, PHN
Assistant Professor
School of Nursing, University of Minnesota
6-101 Weaver-Densford Hall
308 Harvard St. S.E.
Minneapolis, MN 55455
telephone: 612-624-2176
fax: 612-626-2359
email: saewyc at tc.umn.edu