Needlestick prevention still needs attention, diligence

Needlestick injuries were a hot topic in years past, when the health care industry took notice of the risk posed by exposure to hepatitis and HIV in the workplace, but now it is easy to assume that you've taken all the right precautions and lowered the risk as much as possible. But have you really?

Nurses still worry about sharps injuries, and there is some concern that the health care community is letting its guard down now that needlesticks are not the hot topic of the day, says Rebecca M. Patton, MSN, RN, CNOR, president of the American Nurses Association (ANA) in Silver Springs, MD. The most recent statistics from the ANA indicate that nearly two-thirds (64%) of 700 U.S. nurses surveyed say needlestick injuries and bloodborne infections remain major concerns.

"An overwhelming majority of nurses, 87%, say safety concerns influence their decisions about the type of nursing they do and their continued practice in the field," Patton says. "To enhance the safety climate of all health care workers, improvements need to be made to the workplace environment and staffing levels."

The ANA research indicates that the vast majority of nurses, 89%, say increasing workloads and workplace stress levels (84%) affect workplace safety. The majority of nurses surveyed, 59%, say that when pressure mounts, they feel the need to work faster, even if it means taking shortcuts.

Those shortcuts, among other factors, can lead to sharps injuries. Sixty-four percent of the nurses surveyed report being accidentally stuck by a needle while working. Among those nurses reporting needlestick injuries, 74% have been stuck by a contaminated needle while working. When asked how nurses received their most recent needlestick injuries, the top three responses include: while giving an injection (28%); before activating the safety feature (19%); and during the disposal of a nonsafety device (19%).

Patton tells Healthcare Risk Management that reporting rates are reasonably high, but risk managers still may be in the dark about a significant number of needlesticks. The ANA survey revealed that while 91% said they were familiar with their workplace's protocol regarding needlestick injuries, only 79% of those accidentally stuck by a needle while working say they reported the incident.

Attention to needlesticks is waning, and that could result in an increase in injuries, says Angela Karpf, MD, worldwide medical director of medical affairs and an expert in needlestick safety with BD Medical - Medical Surgical Systems in Franklin Lakes, NJ, which manufactures needlestick safety devices.

"There is not a lot of talk now and not many studies being done lately on needlestick prevention," she says. "The ANA survey shows that nurses are still worried about it, but I'm concerned that the health care community may have its focus on other concerns now and is not paying enough attention to needlestick prevention efforts."

About 80% of acute care hospitals have adopted the use of needlestick prevention devices, regarded by the federal Occupational Health and Safety Administration (OSHA) and other agencies as a primary safety strategy, but there still is room for improvement, Karpf says.

"We also see that nurses do not feel there is enough information about needlestick prevention during training," she says. "So, this is not just about using the proper safety-engineered devices. It also is extremely important that the health care providers train employees and continue the education and awareness strategies in the facility. This is a topic that needs ongoing attention."

Karpf suggests that risk managers re-evaluate their needlestick prevention efforts, making sure that policies and procedures reflect the most recent advances in safety technology, but also to ensure that sharps education and training has not been minimized in recent years as other pressing needs came along.

Graham Reynolds, vice president of West Pharmaceuticals in Lionville, PA, which also offers products aimed at preventing sharps injuries, agrees that the health care community is at risk of sliding backwards in terms of needlestick prevention.

"Unfortunately we may not see any real recognition, or response, to the problem until health care providers see the effects from the cost drivers associated with needlestick injuries or legislation that requires more attention to this issue," he says. "It is clear that there is concern among nurses about needlestick injuries, that their worries about this have not gone away, and it is imperative that health care employers not lose their focus. Clearly, the cost associated with needlestick injuries is only going to escalate."


For more information on preventing needlesticks, contact:

• Angela Karpf, MD, Worldwide Medical Director for Medical Affairs, BD Medical - Medical Surgical Systems, Franklin Lakes, NJ. Telephone: (201) 847-6800. E-mail:

• Rebecca M. Patton, MSN, RN, CNOR, President, American Nurses Association, Silver Spring, MD. Telephone: (301) 628-5000. E-mail:

• Graham Reynolds, Vice President, West Pharma- ceuticals, Lionville, PA. Telephone: (610) 594-2935. E-mail: