A device that can be used only once eliminates the risk of cross-contamination, while a needle that is shielded before the device is fired and retracts automatically inside the lancet housing after use eliminates the risk of needle-stick injury.

These safety and infection control considerations are mandatory for pharmacies providing patient services or care programmes that involve taking a blood sample, such as diabetes screening or cholesterol testing. Other desirable benefits when selecting the right device include comfort, control and ease of use. All these benefits combine to enhance both the proficiency of the operator and the effectiveness of the sampling process.

Single-use disposable lancets offer considerable benefits to patients who self-test at home as part of a regular monitoring routine, or who perform tests on a relative or someone in their care. Pharmacists, in their increasingly consultative roles, are in a good position to advise patients about these benefits and encourage better compliance with testing and monitoring regimes.

Safety

With conventional finger-pricking devices, patients tend to re-use lancets rather than insert a fresh one for each test. Tissue debris accumulates on the needle-tip, increasing the risk of contamination and infection. Lancet re-use also blunts the needle, incurring discomfort and increasing tissue damage and infection risk.

Many patients suffer from diminished dexterity or impaired vision, or both. Arthritis, Parkinson’s disease or neuropathic conditions, particularly among older patients, can reduce dexterity, while young children’s smaller hands and fingers are less articulate than those of adults. Poor eyesight, impaired vision or even blindness resulting from conditions such as macular degeneration or diabetic retinopathy are also common among our increasingly ageing population. Patients with these conditions can experience difficulty uncapping and loading a conventional lancet safely and effectively into a finger-pricking device, and so are at increased risk of needle-stick injury and subsequent infection.

Single-use safety lancets eliminate the need for any handling or exposure of a needle and ensure a fresh, sterile needle every time. After use, the device is safe to handle and store before disposal in a sharps container. Lancets with a visual ‘lock out’ mechanism render the device tamperproof and impossible to re-use, adding a further safety benefit. Figures 1–3 demonstrate the build-up of tissue debris and needle-tip deterioration in a lancet that has been re-used.

Figure 1-3

Ease-of-use

There are multiple steps involved in using a conventional finger-pricking device and separate lancet, whereas single-use devices require as few as two. Here is a typical comparison.

Conventional lancet

1.   Remove device end cap.
2.   Load capped lancet into device.
3.   Remove lancet cap.
4.   Replace device cap.
5.   Make any necessary adjustments to the device settings.
6.   Prime (set) device.
7.   Fire device against the test site.
8.   Remove device cap.
9.   Manually remove lancet device.
10.   Immediately dispose of lancet in contaminated sharps container (used needle is exposed and as such is a safety risk).

Single use

1.   Remove protective safety cap.
2.   Fire device against selected test site (as the needle point is protected after use it is safe to carry in a pocket or handbag until a sharps bin is available).

Comfort

Lancing discomfort can be a deterrent to compliance with blood testing routines. With a single-use device, there can be no discomfort or infection caused by repeated use of a blunted, unsterile needle. A preset lancet speed and side-firing mechanism enables consistent penetration of the blood capillaries so that an adequate sample is obtained at every test. This minimises the need to perform a repeat finger prick. Thinner, electro-polished needles with optimally designed needle-tip geometry also contribute to more comfortable lancing.

A device with a side-firing mechanism offers enhanced comfort over one with a top-firing action. The wider surface area makes the device more comfortable to hold and because no downward pressure is needed, as with a top-firing device, any additional discomfort this causes is avoided.

Some safety lancets incorporate comfort-enhancing technology, such as raised dots on the device platform. This feature stimulates the nerve fibres on the test site to promote a strong yet comfortable sensation. It exploits the fact that the brain is unable to perceive simultaneously a comfortable sensation and one that is painful, thereby ‘masking’ the more painful sensation when the needle penetrates.[1]

Convenience

Single-use devices eliminate the need for a separate finger-pricking device and a supply of compatible lancets. They can be used in conjunction with any blood glucose meter or other test equipment. Their safe, simple and speedy operation, with no need for instant disposal, means they can be used at home, at work, school, when travelling, or during sports and leisure activities. This means patients can test safely and easily at any time, wherever they are, making them more likely to keep control of their diabetes or other condition.

Improved safety in the community

With single-use safety lancets, patients not only protect themselves from infection risk, but ensure that members of their community – colleagues, fellow students, family members and carers – are also protected from risk of accidental needle-stick injuries.

Staff in nursing and long-term care homes typically use lancets provided by the residents’ own prescriptions and need to be trained on how to use each individual’s re-usable finger-pricking device. Using single-use lancets means they need only learn to operate one device. Simplicity and uniformity of operation will facilitate compliance and effectiveness of regular monitoring in the care home setting. Here again, single use and needle safety ensures both staff and residents are protected from risk of needle-stick injury and cross-contamination. This is especially important for the sick and elderly, who tend to be immune-suppressed and more vulnerable to infection.

Disposable devices therefore offer benefits in the home and the community, not just the clinical environment. By improving safety, comfort, convenience and compliance in the management of chronic conditions, use of these devices can improve quality of life for all concerned.

Reference

1. Melzack R, Wall PD. The Challenge of Pain 2nd Ed. London: Penguin Book, 1988.