Are We Still in the Dark Ages of Sharps Safety?

The Dawn of Regulatory Protection

In 1991, OSHA issued its Bloodborne Pathogens Standard (29 CFR 1910.1030) to help protect all workers — including healthcare professionals — from this risk. But injuries continued, as did seroconversions, and lawmakers agreed that greater interventions were necessary to stem the tide of sharps injuries.

In 2000, the Needlestick Safety and Prevention Act (NSPA) was signed into law, revising the 1991 Bloodborne Pathogen Standard to require healthcare facilities to implement the following steps:

-- Implement safer medical devices that are appropriate, commercially available, and effective

-- Document consideration and implementation of safer medical devices annually

-- Obtain input for these devices from those responsible for direct patient care; this input must be documented

-- Train employees to use new devices and/or procedures and document training

-- Maintain a log of injuries from contaminated sharps

“Sharps injury prevention has improved significantly since the act was signed into law,” says Peter Rumswinkel, general manager of Sarstedt, Inc. “In addition to more stringent OSHA regulations, HCWs are now more aware of safety hazards and how to prevent them, and industry is continuing to provide more innovative products.”

The Rise of Safety-Engineered Devices

The new requirements of the NSPA and the CDC’s statement that safer medical devices could significantly reduce the number of percutaneous injuries helped launch a movement toward safety-engineered medical devices and the introduction of new words into the infection control lexicon, such as “active” and “passive” safety devices, as well as product category differentiation known as “primary” and “secondary” prevention.

Industry consultant Marilyn Hanchett, RN, PhD, CPHQ, explains, “...devices that use a needle or other sharp component with some sort of protective mechanism to prevent any injury can be described as secondary prevention. That is, the safely technology is secondary to the continued use of the needle or sharp component. Conversely, devices that completely eliminate the use of needles or reduce the frequency with which they must be used are known as primary prevention. The primary focus of this technology is the elimination, or in cases where they cannot yet be eliminated, the reduced use, of the actual needle or sharp component.”⁴

Hanchett observes further, “Unlike the first generation of safety products, the new technology is seeking to eliminate the use of needles and/or sharps. And in cases where current technology cannot yet eliminate needles and sharps, it seeks to reduce the frequency with which they must be used. Specifically, the next generation of safety technology intends to increase safety by removing the potential hazard rather than making contact with the hazard less dangerous.”⁴