|
American Journal of Nursing
2000 February Volume 100, Issue 2
| By
Susan Wilburn, MPH, RN
Preventing Needlesticks in Your Facility Q. Now that OSHA is requiring hospitals to use safer
needle devices, how can nurses be involved in their evaluation, selection,
and implementation so that the choices made are really effective in
protecting health care workers and patients?
A. The Occupational Safety and
Health Administration’s (OSHA’s) new Compliance Directive for the 1991
Bloodborne Pathogens Standard, issued in November 1999, is one of the
latest in a series of victories in securing better protections for nurses
from needlesticks. The ANA worked closely with OSHA, as one facet of the
association’s “Safe Needles Save Lives” campaign, to advocate the
directive.
The directive states that “where engineering controls [safe needle
devices] will reduce employee exposure either by removing, eliminating, or
isolating the hazard, they must be used.” It follows the passage of
landmark state legislation, first in California, then in Texas and
Tennessee, that requires the use of safer needle devices by hospitals.
The National Institute for Occupational Safety and Health (NIOSH) also
published an Alert, “Preventing Needlestick Injuries in Health Care
Settings,” in November. The alert recommends that employers eliminate the
use of needles when safe and effective alternatives are available,
implement the use of devices with safety features, and evaluate use to
determine which are most effective and acceptable.
Also in November, the ANA formed a partnership with the Training for
the Development of Innovative Control Technologies (TDICT) Project to
develop training materials and workshops for nurses in safer needle device
selection and evaluation.
What you should do
Recommendations for choosing appropriate devices include:
- Form a multidisciplinary team to (1) develop, implement, and
evaluate a plan to reduce needlestick injuries that includes immediate
post-exposure management, and (2) evaluate needle devices that have
safety features.
- Analyze sharps-related injuries in your workplace. Data should
identify who, when, where, how, and with what device injuries are
occurring.
- Develop an exposure-control plan based on assessments of how
needlestick injuries are occurring, patterns of device use, and data on
injury and disease transmission trends.
- When selecting a device (see sidebar below), identify its intended
scope of use and any special clinical or design features that contribute
to its safety, efficiency, and user acceptability.
- Evaluate how the device will affect health care worker safety and
patient care.
- Train health care workers in the correct use of the new devices and
schedule promotions of new products. ANA Safe Needles Save Lives buttons
increase awareness.
- Solicit informal feedback and monitor use of a new device to
determine the need for additional training and identify possible adverse
effects of the device on patient care.
- Conduct an annual evaluation according to the OSHA-required exposure
control program.
Resources
Obtain more information on the ANA’s “Safe Needles Save Lives” campaign
and device evaluation forms from the TDICT Project on the ANA’s http://www.needlestick.org/ Web
site, or contact TDICT at http://www.tdict.org/.
Contact OSHA at http://www.osha.gov/.
Contact NIOSH at http://www.cdc.gov/niosh.
Get device-specific epidemiologic data regarding needlestick injuries
at http://www.med.virginia.edu/medcntr/centers/epinet/.
Get a list of all safe devices from http://www.ohb.org/sharps.htm.
The ANA and the University of Vermont will hold a satellite
teleconference on needlestick injury prevention on May 12, 2000. Watch http://www.needlestick.org/ for
more details.
Desirable Characteristics of Safety
Devices |
- The device is needleless.
- The safety feature is an integral part of the device.
- The device works passively (i.e., it requires no activation by
the user). If user activation is necessary, the safety feature can
be engaged with a single-handed technique, allowing workers’ hands
to remain behind the exposed sharp.
- The user can easily tell whether the safety feature has been
activated.
- The safety feature cannot be deactivated and remains
protective through disposal.
- The device uses needles, it performs reliably with all needle
sizes.
- The device is easy to use and practical.
- The device is safe and effective in patient care.
|
Susan Wilburn is the ANA's senior specialist in
occupational safety and health.
|