Are We Still in the Dark Ages of Sharps Safety?

For as long as there have been sharp medical devices and instruments, healthcare workers have been injuring themselves. But it wasn’t until 1981 that the healthcare community started learning about the extent of these injuries through the efforts of Dennis Maki, MD, and Rita McCormick, RN, CIC, of the University of Wisconsin Hospitals, who were poised to publish the very first systematic study of needlestick injuries (NSIs) in the United States.¹ Maki and McCormick investigated 316 reported NSIs occurring between 1975 and 1979, which represented one-third of the hospitals’ work-related accidents. They examined how the sticks occurred and what could be done to reduce or prevent these injuries, including not recapping used needles, and making widely available (and promoting use of) an efficient needle disposal system.

Maki and McCormick discovered that housekeeping (127 cases per 1,000 HCWs annually) and laboratory personnel (104.7 per 1,000) experienced the highest incidence of NSIs, followed by registered nurses (92.6 per 1,000); physicians rarely reported NSIs. Maki and McCormick found that most of the injuries occurred during disposal of used needles (23.7 percent of all injuries), during the administration of parenteral injections or infusion therapy (21.2 percent), drawing blood (16.5 percent), recapping needles after use (12 percent), or handling linens or trash containing uncapped needles (16.1 percent). Sixty percent of the personnel who reported a needle-puncture injury sought emergency room treatment in which management was variable. The total cost of needle puncture injuries in the hospital over a 27-month period was $6,331.

Ten years later, in 1991, Maki and McCormick² published data from a study they conducted over a 14-year period, at a time when AIDS was becoming pandemic in nature. Using the same reporting system and analyses for the 1981 study, Maki and McCormick revealed that despite significantly increased institutional efforts to prevent sharps injuries, the annual incidence increased more than threefold (60.4 to 187 per 1,000 HCWs), reflecting better reporting and increased exposure. Maki and McCormick found that adjusting for inflation, the direct costs of sharps injuries increased from $5,354 to $37,271 annually. The top personnel sustaining injuries were environmental services staff with 305.8 sharps injuries per 1,000, and nursing staff with 196.5 per 1,000.