Are We Still in the Dark Ages of Sharps Safety?

Barry-Dimech comments that St. Mary’s employees usually activate the safety devices, but notes, “I find they do not activate soon enough. Some do not activate, while some activate after they remove the needle from the skin and they use the alcohol wipe.” Barry-Dimech says that in terms of injuries while activating safety devices, of the 11 needlesticks in 2006, two injuries were related to disposal, two injuries were related to used lancets not immediately disposed of, two injuries were related to recapping, and five injuries were related to the safety devices not being activated or not activated soon enough. For the injuries reported in 2007, Barry-Dimech says one injury was related to disposal after blood draw, one was related to ABG, one was related to blood draw, one injury occurred after injection (the device did not activate immediately), one injury was related to an insulin pen, and one injury related to a PICC line insertion. And for the injuries reported so far in 2008, Barry-Dimech says one injury was related to recapping, one was related to an IV insertion, one was related to ABG, and one was related to post-injection.

“I preach to the masses as often as possible,” Barry-Dimech says. “At least they know who I am and for the most part they have stopped reporting the exposure the next day. We have seen a big improvement in surgery after 2006, although it will always be risky.  I now have healthcare workers notifying their supervisor within 30 minutes so we can deal with the exposure immediately (even if it was a stupid thing they did), so that is an improvement. I guess I would say the repeat offenders still have not gotten the message. I would also say that although they activate the device, they often are delayed and that leads to a risky situation. No one should recap, but I still see that. ABGs continue to be an issue because the only safety device is the little plug they put the needle in when they are done. I would also say that for some reason, heparin and insulin sticks have been on the rise. And lastly, I just think they are busy and do not slow down when they are dealing with sharps.”

The Risk of Exposure

One of the most significant occupational hazards faced by HCWs is an injury caused by a contaminated sharp, exposing them to bloodborne pathogens; The Occupational Safety and Health Administration (OSHA) estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of occupational exposure to pathogenic bacteria and viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and others. All occupational exposure to blood or other potentially infectious materials (OPIM) places workers at risk for infection with bloodborne pathogens. OSHA defines blood to mean human blood, human blood components, and products made from human blood. OPIM includes the human body fluids of semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids. OPIM can also mean any unfixed tissue or organ (other than intact skin) from a human (living or dead); and HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions.