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Applied Bionics and Biomechanics

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Retraction
Retracted: Clinical Application of a Safe Blood Sampling
Device with an Indwelling Needle

Applied Bionics and Biomechanics

Received 19 December 2023; Accepted 19 December 2023; Published 20 December 2023

Copyright © 2023 Applied Bionics and Biomechanics. This is an open access article distributed under the Creative Commons
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(1) Discrepancies in scope References

(2) Discrepancies in the description of the research reported
[1] Y. Deng, Z. Lv, Y. Cheng, A. Liu, and Z. Huang, “Clinical
(3) Discrepancies between the availability of data and the Application of a Safe Blood Sampling Device with an Indwelling
research described Needle,” Applied Bionics and Biomechanics, vol. 2022, Article ID
(4) Inappropriate citations 6362905, 5 pages, 2022.
(5) Incoherent, meaningless and/or irrelevant content
included in the article
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Hindawi
Applied Bionics and Biomechanics
Volume 2022, Article ID 6362905, 5 pages
https://doi.org/10.1155/2022/6362905

Research Article
Clinical Application of a Safe Blood Sampling Device with an
Indwelling Needle

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Yeqin Deng ,1 Zhengbing Lv ,2 Yue Cheng,1 Annuo Liu ,3 and Zhengling Huang1
1
2
3
Zhejiang Sci-Tech University, Hangzhou, Zhejiang, China
School of Nursing, Anhui Medical University, Hefei, Anhui, China

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Anhui Maternal and Child Health Hospital, Anhui Medical University, Hefei, Anhui, China

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Correspondence should be addressed to Yeqin Deng; dyq85213@126.com and Zhengbing Lv; zhengbingl@zstu.edu.cn

Received 20 June 2022; Revised 27 July 2022; Accepted 2 August 2022; Published 1 September 2022

A
Academic Editor: Ye Liu

Copyright © 2022 Yeqin Deng et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Background. The traditional indwelling needle catheter is hard and can only complete one puncture at a time. The safety and
indwelling needle catheter is soft, with a large lumen, with high success rate of blood collection, and one puncture completes
two operations, so it is of important value and significance to study the new safety and indwelling needle. To explore the
clinical utility of a novel blood collection device with indwelling needle for blood collection among pediatric patients. Methods.

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A total of 300 children who were admitted to the children’s hospital from March to June 2020 were selected and randomly
divided into the control group (148) and the observation group (152). The control group received venipuncture using regular
needles for infusion and blood collection. For the observation group, a modified indwelling needle device was used for the
procedures. Comparisons were made between the two devices in five aspects: blood sample quality, operation time, needlestick
incidence, related complications, and patient satisfaction. Results. There was no significant difference in coagulation rate

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between the two groups, but slightly lower overall hemolysis incidence in the observation group. The unqualified rate of blood
specimens collected in the observation group was 10.0% lower than that in the control group (P < 0:05). Shorter operation
time, lower incidence of needlestick injuries, and improved satisfaction were observed in the group using the novel blood
collection device. Conclusions. This modified blood collection device is superior to the regular venipuncture needle, in terms of
safety, efficiency, and patient satisfaction; thus, it has potential for broad clinical applications for infusion and blood collection.

1. Introduction

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Intravenous (IV) infusion and blood sampling are routine
and important procedures for sick children for timely diag-
nosis and effective treatment, and most hospitalized children
need vessel puncture and blood sampling. An intravenous
catheter has been most commonly used clinically as a blood
sampling device, allowing long venous access with simple
procedure [1]. Studies show that the incidence of needlestick
injury among nurses in China was 57.3% [2]; the incidence
among intern nurses is even higher, about 60.8% [3]. Safety
needles can be selected to effectively avoid such accidents [4,
5]. Traditional blood sampling devices need to press open
the catheter valve inward to facilitate inserting a syringe into
the valve in order to draw blood. The blood sample in the
syringe is then injected into the sample collection tube.
Connecting a syringe to the catheter valve for blood collec-
tion is cumbersome and typically involves multiple steps. It
also has many disadvantages such as repeated disconnection,
difficult to control blood volume, easy infection, and blood
clotting [6]. When collecting blood samples from children
using the IV catheter, it is easier to make mistakes and inflict
needlestick injuries since they are often uncooperative, rest-
less, and crying [7].
To this end, we have developed a novel blood sampling
device that is more convenient and simple-to-operate and
reduces the possibility of clinical complications. In this
paper, the safe and traditional indwelling needle design has
a thinner needle tube, a softer catheter, and a larger lumen
and greatly improved the success rate of blood collection,
and one puncture can complete two tasks. We evaluate the
safety and utility of this blood collection device among
2 Applied Bionics and Biomechanics

pediatric patients for infusion and blood sampling proce-

dures in contrast with regular intravenous catheters.

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2. Design of the Blood Collection Device
A common intravenous catheter was used for a regular
blood collection procedure, which is composed of a 22-

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24G needle at the top connected with a 5 mL syringe, plus
a blood drawing syringe with a heparin cap connected with
a vacuum collection tube (Figure 1). The details of new
design are shown in Figure 2, comprised of a negative pres-

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sure large-diameter tube (part 1) attached at the end that can Figure 1: Regular blood collection catheter with a syringe attached.
hold and protect the puncture needle (part 2), the connect-
ing soft tubing to the needle (part 3), the puncture needle
sheath (part 4), and a threaded adapter (part 5) at the other
end suitable for Y type or non-Y type indwelling needle con-

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nection. Type Y is an indwelling needle with two exits, usu-
ally with an extension tube: one outlet for injection and one
with a heparin cap; non-Y type is handling indwelling nee-
dles other than Y type and the male (part 6) and female
buckle (part 7) at the exterior of the soft tubing. The assem-

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bled device with all parts is shown in Figure 3. This new
design is more efficient and safer for clinical tasks of blood
collection and infusion for pediatric patients who often
require both procedures and suffer repeated needle punc-
tures, as both procedures can be achieved in a one-time nee-

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dle puncture. To avoid contamination of saline or Figure 2: The structural view of the new blood collection device.
anticoagulant in collected blood sample, a single or multiple
blood collections using this device would be conducted
before infusion treatment, e.g., blood collection followed by

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infusion.

3. Results

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A total of 300 children with the age of 7 years or younger
admitted to our hospital from March to June 2020 were
selected and randomly divided into a control group
(n = 148) and an observation group (n = 152). The control

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group consisted of 78 males and 70 females, with an average
age of 4:5 ± 2:13 years; clinical manifestations include 74
upper respiratory tract infections, 26 diarrhea, 33 pneumo-
nia, and 15 other diseases. The average age for the observa-
tion group was 4:0 ± 2:21 years, which consisted of 82
males and 70 females, with clinical diagnosis of 73 upper
respiratory tract infections, 28 diarrheas, 32 pneumonias,
and 19 other diseases. There is no statistical difference
between the two groups in terms of age, sex, and clinical dis-
ease categories (P > 0:05).
A total of 750 tubes of blood samples were collected, 350
tubes in the control group (148 patients) and 400 tubes in
the observation group (152 patients). The overall hemolysis
rate in the observation group was lower than that of the con-
trol group, with statistically significant difference (P < 0:05),
The hemolysis rate generally has no normal range, but the
normal value of the hemolysis index is 1 : 64. If the hemolysis
index test result is greater than 1 : 64, the probability of
hemolysis is very high as shown in Table 1.
Figure 3: The outline view of the new device after assembly.
The coagulation rate of the control group was 4.3% (10/
230), while that of the observation group was 5.5% (15/275),
statistically not significant between the two (P > 0:05).
In the comparison of the unqualified rate of specimen
collection between the two groups, the unqualified rate of
blood specimens in the observation group was 1.3% (5/
400), which was lower than 9.4% (33/350) in the control
group, and the difference between the two groups was statis-
tically significant (P < 0:05).
The blood collection time in the observation group was
significantly shorter than that in the control group
(P < 0:05), and the incidence of needlestick injury was also
significantly reduced (P < 0:05), as shown in Table 2.
The incidence of complications and patient satisfactions
between the two groups were also compared. The incidence
Applied Bionics and Biomechanics 3

Table 1: Comparison of blood specimens of two study groups.

EDTA tube Blood clotting tube Heparin tube Erythrocyte sedimentation Overall hemolysis rate
Group Dry tube (%)
(%) (%) (%) tube (%) (%)

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20/120
Control 15/115 (13%) 10/50 (20%) 5/55 (9.1%) 1/10 (10%) 51/350 (14.6%)
(16.7%)
15/130
Observation 10/125 (8%) 5/65 (7.7%) 5/70 (7.1%) 0/10 (0) 35/400 (8.6%)
(11.5%)

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X2 0.000 3.346 2.871 0.001 0.000 4.935
P value 1.000 0.067 0.090 0.971 1.000 0.026

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needle prevents the puncture needle from air contamination
Table 2: Comparison of blood collection time and needlestick
and also reduces the chance of needlestick injury to the med-
injury rate between the two study groups.
ical staff. Finally, the male and female adhesive buckle is
Number of Operation Needle stick simple and convenient, which is used to stop blood flow in
Group the tubing during blood draw when the two adhesive pieces
blood specimens time (minutes) injury rate (%)

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Control mate, not only avoiding damage to the soft tubing but also
350 6:2 ± 1:3 32 (9.1%) improving the efficiency of blood collection. In addition,
group
Observation
strict disinfection procedures and catheter flushing were per-
400 4:7 ± 1:1 6 (1.5%) formed to avoid contamination. More importantly, the
group
newly designed blood sampling device has a low cost of
X2 5.624 22.669

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about half a US dollar, 2-3 fold cheaper than the price of
P value <0.05 <0.05 similar device in China, thus saving a large amount of
expenses for hospitals and testing labs if broadly used.
The overall hemolysis rate in observation group is a bit
of complications associated with the use of new blood collec- lower than that in the control group. Indeed, children are

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tion device in the observation group was significantly lower
than that in the control group (P < 0:05), and similarly, the
rate of patient satisfaction was significantly higher in the
observation group (Table 3).
often uncooperative for a venipuncture at the second time
due to fear of needle and thus more difficult to puncture
and prone to hemolysis [11]. The chance of hemolysis can
be reduced by some methods, such as collecting blood from

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the indwelling catheter in the anterior elbow area [12].
4. Discussion In the observation group, the percentage of unqualified
blood samples collected using the new device was reduced,
The most common method of blood collection in hospitals and the operation time was shortened more than one minute
or clinics is to use disposable blood collection needle, which relative to the control group. Insufficient blood is one of the

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requires arterial or venous puncture separately [8]. In order
to reduce the number of puncture, an indwelling needle is
commonly used in a clinic or hospital for sick children for
dual purposes of blood collection and infusion treatment
reasons for unqualified blood samples due to the complexity
of this operation for pediatric patients [13]. Our design sim-
plified the tasks of blood collection and infusion into a single
operation that is convenient and fast so as to improve the
efficiency of first aid in health settings.

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[9]. However, the traditional indwelling needle technique
needs connection and disconnection of the needle to allow
the syringe to be inserted into the sample collection tube
for blood collection. This operation is repetitive and compli-
cated and requiring the right force from both hands to insert
the needle into or withdraw from the tube, which may affect
the stability of the needle in the vein at the other end [9].
This procedure is especially difficult when performed on
children who are often crying and moving, with minimum
cooperation, thus more likely causing operational errors or
high risk of needlestick injuries [10].
Our design of safe intravenous blood collection device
has several features with advantages in clinical practical use
over regular blood sampling device. First, the needle-free
threaded adapter can reduce the number of punctures and
lower the incidence of needle injury of medical staff. Second,
the negative pressure tube prevents the puncture needle
from hurting the medical staff and provides a safer and ster-
ile operation area. Third, the sheath surrounding puncture
Our data suggest that the incidence of needlestick injury
and complications decreased among the group using the
new blood collection device, and the patients’ satisfaction
also improved. This innovative device has combined the
multiple clinical tasks of blood collection, infusion, and
intravenous indwelling function into one simple operation,
which improve the efficiency of blood sampling and reduce
operation time. In the process of blood collection, it also
reduces the risk of infection and needlestick injury.
This study has several limitations. First, the sample size
in the study cohort is limited, so a larger scale study for com-
prehensive evaluation of this device in children might be
needed. Second, this device was not evaluated in adult
patient groups because the study was conducted in chil-
dren’s hospitals. Lastly, the length of time for a needle
indwelling in the vein or types of medication used in infu-
sion was not included as confounding factors when identify-
ing complications among the two study groups.
4 Applied Bionics and Biomechanics
Table 3: Comparison of incidence of complications and patient satisfaction between the two groups.
Number of Tube blockage Tube detached
Group
patients (%) (%)
Control group 148 5 (3.3%) 9 (6.1%)
Observation
152 2 (1.3%) 5 (3.3%)
group
X2
P value
5. Conclusions
In summary, this safety blood collection device can be con-
nected easily with different types of indwelling needles using
the threaded adaptor, simple to operate and no need of being
disconnected repeatedly. It overcomes the shortcoming of
the traditional IV indwelling needle in China that serves a
single purpose of infusion. One needle puncture in pediatric
patients is enough for multiple blood drawings and infu-
sions, which effectively reduce the operation time and the
incidence of needlestick injury and also save significant cost
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for hospitals and other health settings. Of course, this new
device should be applicable in adult patients for the same
procedures and worthy of further investigation in the future.
6. Methods
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6.1. Study Groups. All experimental studies were carried out
in accordance with Anhui Medical University clinical study
guideline and regulations. All experimental protocols and
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study design were reviewed and approved by the Anhui
Medical University review board. Informed consent was
obtained from either parent or legal guardian of children
in the study cohorts.
A total of 300 children admitted to our hospital from
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March to June 2020 were selected and randomly divided into
a control group (odd number in the last digit of patients’
admission number) and an observation group (even number
in the patients’ last digit of admission number), with 148 as
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the control group and 152 as the observation group. The
clinical operation of blood collection was performed by pedi-
atric nurses with standardized training and extensive experi-
ence according to the clinical operation standards. The
following are the inclusion criteria: (1) those who need to
receive both intravenous infusion and venous blood sam-
pling on the day of admission, (2) less than or equal to 7
years old, and (3) the guardian of the child agreeing to par-
ticipate and sign an informed consent. The exclusion criteria
include (1) neonatal hemolysis, (2) patients with skin burns,
and (3) children with hypercoagulable state.
6.2. Comparisons of Efficiency, Safety, and Complications
Associated with the Use of Two Different Blood Sampling
Devices. The hemolysis rate and coagulation rate of the sam-
ples and percentage of unqualified samples were compared
between the two groups. Two professional inspectors inde-
pendently evaluated the quality of blood collection samples
including hemolysis and coagulation. The hemolysis rate
Liquid leakage Total complications Satisfactory rate
(%) (%) (%)
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19 (12.8%) 33 (22.3%) 118 (79.7%)
5 (3.3%) 12 (7.9%) 150 (98.6%)
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12.2 28.3
<0.05 <0.05
was calculated based on the number of hemolytic tubes
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divided by the number of total tubes. The coagulation rate
(%) is the ratio of the coagulation tubes out of total tubes.
To meet the clinical blood collection standard, the sample
collection volume must be between 2.2 and 3.2 mL for blood
coagulation tube, 1.5-1.7 mL for blood sedimentation tube,
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3-5 mL for drying tube and heparin tube, and 1-3 mL for
EDTA tube. Complications include tube blockage, tube
detached, and liquid leakage. The rate of total complications
is equal to the sum of all complication occurrences divided
by the number of total patients.
The time spent for the blood sampling was determined
using a stopwatch from the beginning of skin disinfection
to blood collection and to IV infusion. The incidence of nee-
dlestick injury and related complications were recorded. The
patient satisfaction questionnaire was designed with refer-
ence to Kantartjis et al.’s literature [14], comprising of four
aspects: nurse’s blood collection technology, blood collection
time, patient’s cooperation, and patients’ knowledge about
blood sampling via education, with a total score of 100
points. The parents or guardian of the patient would answer
the questionnaire if a patient was too young and unable to. A
score of ≥90 was considered satisfactory, 70-89 was
considered basically satisfied, and <70 was considered dis-
satisfied. The rate of patient satisfaction ð%Þ = ðsatisfaction
+ basic satisfactionÞ/total number of patients × 100%.
6.3. Statistical Analysis. A t-test was used to compare the
numerical values between two groups, while chi square value
(X 2 ) test used for percentage comparison between groups.
The statistical calculation was performed using SPSS23.0
software, with P < 0:05 being considered statistically
significant.
Data Availability
The datasets used and/or analysed during the current study
are available from the corresponding authors on reasonable
request.
Ethical Approval
All experimental protocols and study design were reviewed
and approved by Anhui Maternal and Child Health Hospital
review board.
Applied Bionics and Biomechanics 5

Consent lytical problem in the serum of newborns and adults,” EJIFCC.,

vol. 31, no. 1, pp. 6–14, 2020.
Informed consent was obtained from either the parent or [12] N. J. Heyer, J. H. Derzon, L. Winges et al., “Effectiveness of
legal guardian of children in the study cohorts.

Conflicts of Interest
This design was awarded a national utility model patent
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practices to reduce blood sample hemolysis in EDs: a labora-
tory medicine best practices systematic review and meta-anal-
ysis,” Clinical Biochemistry, vol. 45, no. 13-14, pp. 1012–1032,
2012.
[13] X. Lai, P. Yang, Y. Zhang, J. Cao, and L. Zhang, “Analysis of

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(zl201822182602. X) in China. All other authors declare no factors influencing the generation of unqualified clinical sam-
conflict of interest. ples and measures to prevent this generation,” Annals of Lab-
oratory Medicine, vol. 32, no. 3, pp. 216–219, 2012.
Acknowledgments [14] M. Kantartjis, S. E. F. Melanson, A. K. Petrides et al.,
“Increased patient satisfaction and a reduction in pre-

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This project was funded by Hefei Science and Technology analytical errors following implementation of an electronic
Research Project (grant Heke 2017-03-69). specimen collection module in outpatient phlebotomy,”
Laboratoriums Medizin, vol. 48, no. 3, pp. 282–289, 2017.

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