Sharps accidents are commonly referred to as the unlisted never event, but instead of patients, clinicians are typically the ones affected. The American College of Surgeons (ACS) points to data to reiterate this point on its website:
- Patients’ blood makes contact with the skin or mucous membranes of OR personnel in as many as 50 percent of operations, with cuts or needlesticks occurring in as many as 15 percent of operations.
- Those most likely to experience sharps injuries in the OR are:
- Surgeons and first assistants (59 percent)
- Scrub personnel (19 percent)
- Anesthesiologist (6 percent)
- Circulation nurses (6 percent)
ACS and the Association of periOperative Registered Nurses (AORN) have guidelines to reduce these occurrences, but these recommendations, such as engineering sharps injury prevention devices and using blunt tip suture needles, are only possible if suppliers provide the means. To figure out how technology supports these guidelines, Surgical Products connected with Patty Taylor, the vice president of professional education and clinical affairs at Ansell.
How can technology reinforce sharps safety recommendations?
Taylor: Safety is defined as avoiding harm to people resulting from unsafe acts and preventable adverse events. Sharps safety technology continues to evolve, and sharps injury prevention devices have transitioned into second- or third-generation technology with continuous improvements in design, function, performance and overall safety. This new technology represents an opportunity to reduce the number of injuries, and their introduction should be accompanied by education and training for nurses and other professionals to enable them to establish safer practice with regard to the use, care and disposal of sharp items.
How can sharps safety be approached systematically?
Taylor: Improving the culture of safety within healthcare is essential to prevent or reduce injuries. Safety cultures consist of shared beliefs, practices and attitudes which shape our behavior. However, a culture of safety created and sustained by just the nursing staff will not be considered legitimate if the culture excludes other groups within the hospital. It will not be valued and accepted — nor will it facilitate improved safety throughout the hospital or OR. A team/multidisciplinary approach to sharps safety is crucial for success. Safety is everyone’s responsibility. Working with other hospital staff, including front line workers from a variety of services, including surgeons, ensures that needed resources, expertise, and perspectives are included in the selection and acceptance of safety devices and education of safety practice.
What are common errors in sharps safety?
Taylor: Believing that simply mandating the use of safety engineered devices will result in decreased injuries. Just having the sharps safety device on the shelf does not equate to use, proper use, nor reduction in injury. The December 2012 EPINet Report for Needlestick and Sharp Object Injuries reported that safety devices were implicated in 36 percent of reported injuries and non-engineered safety devices in 60 percent. When the safety device was used, it was fully activated in 10 percent of the injuries, partially activated in 23 percent of the injuries and not activated in 65 percent of the injuries. Additionally EPINet reported that when the safety device was used, 50 percent of the injuries occurred before the device was activated, 35 percent occurred during activation, and 23 percent of injuries occurred after activation/after use.
Education, acceptance and engagement of staff on the use of safety devices as well as selection of safer, user-friendly safety devices and focused work practice controls are critical to reduce injury.
What do we know about blood-borne pathogens and sharps safety?
Taylor: Campaigns from the Occupational Safety and Health Administration (OSHA), Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have increased awareness that sharps injuries are primarily associated with occupational transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), and may also be implicated in the transmission of more than 20 other pathogens. Furthermore, the CDC estimates hospital-based healthcare workers in the United States suffer more than 384,000 sharps injuries each year, or more than 1,000 sharps injuries every day.
How has technology reacted to support sharps safety?
Taylor: Through the voice of the customer, technology has evolved with more intuitive safety devices that are better, safer and more user-friendly than previous generations.