ECRI: Sharps injuries among top hazards in HC

Report highlights worst device hazards

Sharps injuries rank eighth in the top 10 device hazards of 2012, according to ECRI Institute, a research organization and evidence-based practice center based in Plymouth Meeting, PA. That places sharps injuries on par with surgical fires (No. 7) and anesthesia hazards due to incomplete pre-use inspection (No. 9).

"It's an ongoing concern we've had," says Chris Lavanchy, engineering director of ECRI's Health Devices Group. "Sharps injuries occur on a regular basis."

Hazards ranked high on the list based on their potential danger, the frequency and number of people affected, and the likelihood that it could result in a high-profile, public incident. Despite progress made on needle safety, about 1,000 needlesticks occur every day, the Centers for Disease Control and Prevention estimates.

"You have health care workers who are injured fairly often," says Raylene Ballard, MS, MT (ASCP), senior project officer with the Health Devices Group.

Safety devices still aren't available for some procedures. But overall, the safety technology has advanced significantly in the past decade. Reducing sharps injuries requires a renewed commitment, says Ballard. In fact, ECRI is evaluating current devices for a future report, she says.

Here are some steps that hospitals and other health care employers can take to reduce the risk of sharps injuries, according to Lavanchy and Ballard:

Review your injuries. Your needlestick logs contain important information about gaps in sharps prevention. Where are your injuries occurring? With what devices? When are they occurring? "If you have a lot of people being injured while they're trying to activate a safety device, maybe you need to find something that activates differently," suggests Ballard.

Define your objectives. Focus on the areas where many of your injuries are occurring. Take a new look at areas where there is no preventive device. Alternate sites, such as home health care, long-term care and physician offices, may need attention because they tend to have lower rates of use of safety devices. Make an action plan based on your objectives, advises Ballard. "You need to prioritize your efforts," she says.

Evaluate available options. The U.S. Occupational Safety and Health Administration requires you to review your exposure control plan every year. Your sharps safety committee should include representatives from risk management, materials management, nursing, clinical laboratory, and pharmacy, as well as the patient safety committee, frontline healthcare workers and housekeeping staff, says ECRI. Consider various factors in the real-life environment, advises Ballard. For example, consider if someone could use it right-handed and left-handed.

"How easy is it to use in low light conditions? Many times health care workers are delivering health care at night or in low light conditions," says Ballard. "If your hands are wet, does that affect the way it works? Where are your hands when you activate the device? Is it possible that one hand is pushing or sliding something that puts it closer to the needle? Is there a way to do it that is one-handed?" You also may want to talk to an employee health professional at another facility that uses the device you are trialing, she says.

Boost your training. "You need to make sure everybody on your staff has received adequate training," Ballard says. If health care workers don't feel comfortable with the sharps safety device, they may not activate it. Make sure that agency nurses, new trainees, and even nurses who float from a different unit are given enough instruction on the safety devices, she says.

Seek champions for sharps injury prevention. Administrative support is the key to a successful sharps injury program, says Ballard. "If the administration feels this is important, that filters down and it helps to keep everybody onboard," she says. "The health of our employees is important. Avoiding injuries by using devices that are well-designed is important." It's also important for someone to oversee sharps safety with an emphasis on continual improvement, she says. That should include frontline workers who will provide feedback. "You need to try to find the people who have an interest in it and they'll help keep it moving along," she says.

[Editor's note: The ECRI report on top device hazards is available (with free registration) at www.ecri.org/2012_Top_10_Hazards.]