Reducing sharps injuries
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Since OSHA adopted
new regulations in 2001 requiring health care institutions to move
to safer medical devices, hospitals, clinics, laboratories, and
others have developed plans to comply.
typically establish a multidisciplinary task force, which must include
workers who use the devices, to evaluate new technology for sharps
safety and make recommendations. The plan must be updated and the
technology re-evaluated annually.
for Professionals in Infection Control and Epidemiology, supported
by the vendor Portex, recognizes outstanding sharps safety ideas
in a recently inaugurated contest. Brenda Beauchamp, Portex’s
marketing director for global needle safety, says the contest started
in 2001, after the OSHA regulations became effective.
to inspire people involved in sharps control who aren’t usually
recognized,” she says. “You don’t have to invent
some fancy new device. It’s how you implement your plan, it’s
how you teach your workers, it’s how you evaluate these devices
... Everything you do is important.”
Here are comments
from two of last year’s winners in the second annual Sharps
Kuranga, infection control coordinator at McCullough-Hyde Memorial
Hospital, Oxford, Ohio, helped set up a team that devised and implemented
a new safety plan for the 60-bed rural hospital.
everyone,” says Kuranga, including nursing, the lab, radiology,
anesthesia, surgery, ambulatory care, materials management, employee
health, infection control, human resources, and administration.
had to use the sharps tested options covering intravenous catheters,
needleless IV administration, phlebotomy, and injections. Those
four were identified as high-risk devices based on rates of injury
for the previous four years.
After the evaluations,
the safety group selected approved devices, and employee training
began. “We did the trials with different safety devices. Then
we went through and trained people,” Kuranga says. Problems
were tracked to the device or to the training.
just evaluate devices. You also evaluate your training and your
education,” Kuranga notes. Each time new workers come onboard
is an opportunity to do so. In addition, all workers are retrained
on safety devices at least once a year.
of sharps safety is never completed,” she says. “It
involves continuous surveillance and education.” However,
it’s much easier to make changes when those who use the devices
can make comments and recommendations, she adds.
at McCullough-Hyde have dropped from a high of 15 in 1995 to only
two each in 2001 and 2002, after the new program was initiated.
Injuries had averaged seven each in 1999 and 2000.
Allen, RN, employee health nurse at Thomas Hospital, Fairhope, Ala.,
helped implement a new safety plan at that 150-bed hospital. She
says the primary impetus for the plan was OSHA’s mandate for
implementing safer devices.
evaluated different brands of safety syringes, blunt tip syringes,
and safety IV catheters and made recommendations to the hospital’s
safety control committee. “Lab personnel also selected, evaluated,
and implemented safety devices for phlebotomy procedures, including
syringes, butterflies, and Vacutainers,” Allen says.
At first, she
adds, employees were given the option of using safety or nonsafety
devices, but most of them continued to use nonsafety products because
that’s what they were familiar with. Then safety devices were
made mandatory, and all nonsafety devices were removed. “Exposure
rates [from needlestick injuries] dropped significantly,”
She agrees with
Kuranga that new devices must be evaluated and training provided
continually. “We’re just going through now [in February]
and re-evaluating our devices,” she says. “Technology
changes every day, and we must provide opportunities for staff to
evaluate better safety devices.”
may soon switch to a new IV catheter because patients and nurses
have expressed dissatisfaction with the one they’re now using.
“The nurses are having to stick patients more than once,”
Allen says. “We’ve had a rep here demonstrating a new
product and giving us some samples. We’re going to see if
nurses prefer it over the other one.”
In 2002, Thomas
Hospital’s average rate of needlestick injuries was 3.7 percent
per 100 occupied beds, down from 5.7 percent in 2001 and 8.35 percent
in 2000. “Our benchmark is five percent,” says Allen,
“so we’ve been able to stay below that for the past
12 months. We’re happy with that, and so are our employees.”