Effective ways for preventing needlestick injuries at your facility

Occupational exposure to blood and bodily fluids continues to be a major problem for healthcare workers.

This is why needlestick and blood exposure presentation for every patient and every procedure is important. The use of safety engineered devices is a requirement by OSHA, CMS and the Joint Commission. In addition, the financial cost and emotional anxiety of the injury for the healthcare personnel and their facility is huge.

Why is occupational exposure an issue?

• There is an increasing number of patients accessing health care clinics and physician offices with infectious diseases such as Hepatitis C or HIV.⁵ This increases the risk for accidental exposure to a larger pool of healthcare personnel

• Changing risks associated with co-infection. There is also an increase in patients with one or more blood borne pathogens, such as HIV/Hepatitis C, that are co-infected with another blood borne pathogen or a multi-drug resistant bacterial infection such as MRSA. This increases the risk of spreading these infections to healthcare workers via accidental needlesticks or other sharps-related injuries

Key insights

1 | Injury & exposure

The International Safety Center Exposure Prevention Information Network (EPINet) tracks incidents of needlesticks, along with injury from sharp items like blades and broken glass, within the healthcare industry. According to EPINet, the top three areas of injury and exposure are:

• Needlesticks – Disposable syringes/needles cause most incidents reported by healthcare workers with 40% injuring nurses

• Contaminated sharps – Includes sutures, scalpels, broken glass, lancets, scissors and blood collection devices such as vacuum tubes and phlebotomy needles

• Blood and body fluids – EPINet data shows that compliance with or use of personal protective equipment is still quite low no matter the healthcare setting.

  • 81% of exposures touched unprotected skin due to lack of PPE protection

2 | Cost of needlestick injuries

• According to the Association of Occupational Health Professionals in Healthcare (AOHP), initial treatment for a needlestick injury can run between $800 and $6,000, depending on treatment provided⁶

• OSHA fines have increased in recent years and can now be up to $12,000 per violation

3 | OSHA's blood-borne pathogen standard requirements

• Documentation of your facility’s exposure control risk plan

• Engineering & work practice controls

  • Safety-engineered device use and activation

  • Disposal protocol

  • Frontline employee evaluation & selection of safety devices

  • PPE availability and use

• Annual staff training

• Documentation and procedure regarding employee HBV vaccination

• Post-exposure procedures

• Recordkeeping and BBP sharps injury log. OSHA launched a new requirement 2016 that facilities must submit documentation electronically to improve tracking of workplace injuries and illnesses. Reporting runs from July 1 – Dec 1 of 2017

How to help reduce risk in your facility

1 | Include frontline employee feedback

Research shows that when non-managerial frontline employees are part of the evaluation and selection of safety devices, the likelihood that these employees will actually use the safety devices improves. Including front line employees in your feedback loop creates a facility-wide culture and climate of safety and fosters greater compliance.

Importance of frontline employee feedback

• Safety devices are evaluated and selected by non-managerial frontline employees

• Improve the use of safety devices

• Improve activation of safety features

• Decrease downstream, non-user injuries

• Create a culture and climate of safety

2 | Simplify the process for selecting devices

There are three primary criteria that workers should use to select a new safety device:

1. Ease of use

2. Patient safety and comfort

3. Device must be safe for the user

“Remember, selecting a safer device based solely on the lowest cost is not appropriate. Selection must be based on employee feedback and on device effectiveness.”
– Occupational Safety and Health Administration

3 | Overcome resistance to change

Improving your facility’s use of proper safety devices can involve both institutional and personal motivators. Institutional motivators include economic reasons such as maintaining productivity, since there are fewer days away from work resulting from injuries and exposures, and remaining competitive in recruitment and retention of skilled personnel.

Personal change motivators include making sure that safety devices are available and that activation of safety features are implemented, proper training on the use of devices and PPE, and making sure that healthcare workers understand the benefit to them personally in helping to protect themselves, their family, and the patient.

1 Occupational Safety and Health Administration https://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html
2 American Nurses Association http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/Factsheets-and-Toolkits/Fact-Sheet.pdf, 2010|
3 Occupational Safety and Health Administration https://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html
4 Infection Control Today, http://www.infectioncontroltoday.com/news/2013/08/prevention-of-needlestick-injuries-can-save-us-healthcare-system-more-than-1-billion-annually.aspx, 2013
5 Centers for Disease Control and Prevention, http://www.cdc.gov/media/releases/2016/p0504-hepc-mortality.html, 2016
6 Association of Occupational Health Professionals in Healthcare, AOHP Study: Successfully Reducing Wing set-related Needlestick Injuries, Spring 2014