While national trends show sharps injuries are increasing, a 10-hospital system in Chicago reduced needlesticks by 70% after implementing a passive device that requires no action by the worker to trigger protection, Hospital Employee Health has learned.
Dawn Lantz, MSN, manager of employee health at Advocate Medical Group, spearheaded the effort after studying needlestick prevention as part of her master’s degree in nursing. April 2019 marked one year since the last of the 10 hospitals had implemented the safety equipment.
The passive devices are more expensive, but that is balanced out by reduced costs associated with follow-up for needlesticks and administration of post-exposure prophylaxis, she explains.
“We are actually at a break-even point right now,” she says.
Of course, that calculation does not include the mental anguish and emotional toll of needlesticks, as healthcare workers await word that they have not been infected with a bloodborne pathogen. Lantz described the project to HEH in the following interview, which has been edited for length and clarity.
HEH: What motivated you to take on the problem of needlesticks?
Lantz: When I first started here five years ago, I noticed we had a large number of needlesticks across our entire organization. We were averaging anywhere from 400 to 450 a year. I started looking into the trends and the highest numbers. A lot of our staff were being stuck for subcutaneous injuries; for example, giving heparin injections, insulin injections. There were a lot of unnecessary injuries.
I did my capstone project for my MSN on needlestick injuries. During my research, I found that the best practice out today is the passive safety device. The research has shown that passive safety devices can reduce needlestick injuries by up to 90%.
HEH: How did you present this idea to your hospital?
Lantz: I talked with the nursing executives, and we put together a multidisciplinary team to look at our injuries and identify what steps we could take to bring them down. The team consisted of nursing, employee health, patient safety, and supply chain.
In phase one, the team didn’t feel we should move forward with changing products for multiple reasons. Of course, cost was a big one because passive devices are more expensive. Also, we were in a supply contract with a company that did not have a passive safety device. So we tried doing computer-based training [CBT] and assigned it to all nursing staff. This was training on how to safely use needle devices. We got 98% compliance of staff in reviewing the CBT and taking an after-test.
But on evaluation after three months, we found that needlestick injuries may be going up — not down. We brought the team back together, and at that point, it was decided that we would move forward with best practices research, which was passive safety devices.
HEH: After you brought in the manufacturer of the passive safety devices for a presentation to the team, you decided to go ahead?
Lantz: We had to do a whole crosswalk with all of our needles, and decided just to do subcutaneous injection first. We did an evaluation at one hospital first just to see how it would work. We brought in the vendor to do hands-on training. Our nursing team was also there to do hands-on training, which was mandatory. Every nurse had to be signed off on it. Now, every new nurse who comes in for orientation is trained the exact same way.
HEH: Can you explain how the needle in this syringe passively retracts?
Lantz: There is no mechanism and no action on the part of the user that they have to do to get the needle to retract. They just continue to push the plunger in and the needle automatically retracts at the end of the injection. They never see a dirty needle. After the [implementation] and training, I evaluated injuries for 30 days and we did not have one needlestick. We rolled it out systemwide one hospital at a time with the same training — hands-on, return demonstration, and sign-off. We currently are at a 70% reduction in needlestick injuries.”