OSHA moves on IV safety

The push for safer intravenous needle technology is gaining momentum at the national level. The Atlanta-based Frontline Healthcare Workers Safety Foundation, held a national conference on bloodborne pathogen transmission and other safety issues for health care workers, in Washington, DC, in August. (For further discussion of needle safety, see Hospice Management Advisor, August 1998, pp. 97-99, and June 1998, pp. 75-77.)

In a speech at that conference Charles Jeffress, secretary of the federal Occupational Safety and Health Administration (OSHA) in Washington, DC, called for a comprehensive national strategy to end the needlestick epidemic. "I'm committed to finding a way to reduce needlesticks," he said.

OSHA plans soon to publish a formal request for information on needlestick prevention in the Federal Register. Possible ideas range from instituting emergency regulations requiring safety needles to revising compliance rules in order to allow OSHA inspectors to cite hospitals and other health care employers for failure to provide safety devices for their workers.

Among the dramatic facts cited at the Frontline conference is the estimate that one out of every seven health care workers is stuck by a needle each year. Former U.S. Surgeon General C. Everett Koop, MD, speaking by videotape, related that he once contracted hepatitis via needlestick. Also featured was Linda Arnold, RN, BSN, a former nurse and current worker safety advocate from Norristown, PA, who described how she contracted HIV from a needlestick in 1992. These and other speakers reiterated that the time has come for action on needlesticks, given that safer technology has been available for more than a decade.

"We know that safer alternatives to standard syringes, IV equipment and suture needles exist," Jeffress said. "I keep some samples on my desk given to me by Andy Stern of SEIU (the Service Employees International Union). And some data from the Centers for Disease Control and Prevention in Atlanta indicate that most needlesticks occur when health professionals use standard devices without a safety feature."

Sen. Barbara Boxer and Rep. Pete Stark, both of California, have been lobbying OSHA for new safety rules. Meanwhile Cal-OSHA (California's state OSHA agency) has drafted new regulations requiring that safety devices be used in that state. OSHA's Jeffress recommends that health care facilities adopt a comprehensive programmatic approach to evaluating the problem at their facility, involving employees in selecting safer devices, training them to use the new equipment effectively and safely, and then evaluating the results. OSHA has also published a new, easy- to-follow needlestick prevention training booklet, which can be obtained on its Web page (www.osha.gov).