Special Report

New needle standards must be practicable’

By Virginia Wright Simone
Locke Reynolds LLP, Indianapolis

Health care providers, take note: Nov. 6, 2000, President Clinton signed into law HR 5178, known as the Needlestick Safety and Prevention Act. This act implements changes in the bloodborne pathogens standard that was put into place in 1991 under the Occupational Safety and Health Act, and is intended to reduce the number of needlestick and other percutaneous injuries experienced by health care workers, presently occurring at a rate of 600,000 to 800,000 incidents a year.

The new standards apply to all employers who are regulated by Occupational Safety and Health Administration (OSHA) bloodborne pathogen standards, and requires the identification, evaluation, and use of safer medical devices. Further, in meeting these new standards, employers must now actively consult with nonmanagement employees.

Relying on statistics from the Centers for Disease Control and Prevention, the act emphasizes the use of training, education, improved medical devices, and safer work practices, estimating that an employer who meets the new requirements may reduce the rate of contaminated sharps injuries by up to 88%.

While much of the act merely encourages employers to take a closer look at safety-oriented sharps technology, a number of requirements were put into place to ensure better monitoring of injuries and the ability of those health care workers who are at greatest risk for injury to request specific safety-oriented devices.

Complete documentation will be the key to establishing an employer’s compliance. An employer must now:

• Consider (and document that consideration) "safer medical devices, such as sharps with engineered sharps injury protections and needleless systems" when establishing engineering controls.

• Amend its exposure control plan to adequately reflect changes in technology that reduce or eliminate exposure to bloodborne pathogens.

• Document annually how it reviews, evaluates, and considers this new technology.

• Document its solicitation of nonmanagerial employees regarding identification, evaluation, and selection of effective engineering and work practice controls.

• Create and maintain an injury log for all sharps injuries. The log must contain certain required information and kept confidential.

As a final point, while it’s true that frontline health care workers now have a greater voice in the selection and use of medical devices, it’s important to note that the act only requires an employer to use the cutting-edge technology to the extent "practicable."

What that means is that although an employer will be required to ask an employee his or her opinion on new technology, and use that technology if possible, if it is prohibitively expensive, experimental, or otherwise impracticable, the employer does not violate OSHA standards by refusing to use it.