Infection Control Today - 09/2003: Perspectives

Central Processing Staff Are Vital Task Force Team Members

By Diana Baranowsky, RN, BSN, MS, CIC

The Needlestick Safety and Prevention Act, which became effective April 18, 2001, mandates important changes to the Bloodborne Pathogen Standard issued by the Occupational Safety and Health Administration (OSHA). Compliance with these new regulations helps OSHA and employers achieve a goal of making the workplace safer for healthcare workers (HCWs).

By issuing a sentinel event alert in August 2001 requiring compliance with this OSHA act, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) likewise reinforced its collaboration to protect HCWs and patients. The techniques that are used to protect HCWs from needlestick can also protect patients. The existing Bloodborne Pathogen Standard established in 1991 required the use of safety-engineered sharps and need-less systems whenever possible. The new act strengthens and broadens this standard with its requirement of selecting and implementing safer needle devices as they become available, involvement of non-managerial frontline workers in evaluating and selecting safety engineered devices, and maintaining a sharps injury log which contains at a minimum the type and brand of device involved in a needlestick injury and a description of the incident.

Even prior to the act, the Stamford Hospital in Stamford, Conn., had established a Safety (Needle) Device Task Force to set priorities and strategies for prevention of needlesticks among its HCWs. Staff from the central processing (CP) department was an integral part of this team. Under the direction of the infection control committee, this multidisciplinary task force encouraged HCWs to report needlestick injuries and any needlestick hazards they observed in the work environment. It analyzed and trended needlestick/sharps-related injuries, and involved frontline HCWs in the selection and evaluation of devices with safety features. It also evaluated the effectiveness of its prevention efforts.

A valuable asset to the current task force is the input it receives from CP employees. As an infection control nurse, I have always recognized and valued the efforts of CP and its tremendous impact on patient safety. Now, as chairperson of the task force, I see an even greater dimension of the responsibilities of CP—their commitment to the safety of their customers, their peers and other HCWs. This facet seems to flourish in support of the task force’s commitment to comply with the new standards.

Traditionally, CP has been meeting the clinical needs of the operating room (OR) and surgical staff as well as the needs of direct patient care staff. By soliciting the input of CP workers regarding work practices and devices that pose injury hazards, this staff accepted empowerment to grow and to think outside of the box in order to identify and solve problems.

When the task force was discussing the evaluation of safety disposable scalpels in the OR, CP recommended that they proceed with the removal of the reprocessed blade handles from the kits which they assemble (i.e., circumcision tray, pacemaker wire insertion tray) and replacing them with safety disposable scalpels facility-wide. The Stamford Hospital CP staff thought in terms of system issues when they took the initiative to explore safety needle devices, which could be autoclaved in order to accommodate the emergency department (ED) physicians whose work practices are to have a needle included inside the sterile suture kit. These are examples of how the support and input of CP employees can ensure a sharps injury prevention environment.

CP individuals have also been involved with the task force efforts to improve the safety of our hospital’s healthcare practice issues. It was CP who recommended that Llabor and delivery nursing staff pilot the P-2 Safety Plus gloves used in CP for that staff’s use during post-delivery cleanup. Through their input to the task force, CP personnel are promoting collaborative partnerships in the workplace.

This is the approach they have been using all along when they work closely with teams from other disciplines such as anesthesiology and respiratory therapy on a regular basis.

It is evident by their commitment to an injury-prevention model that CP personnel know that their contribution to their customers and a safe environment makes a difference. I have highlighted just a few of the initiatives of the CP frontline HCWs; I am confident that this is just the beginning.