NAPPSI's Safety Device List: An Important Tool for Infection Control and Safety Professionals
By Marilyn P. Hanchett, RN
Editor's note: In the February 2003 issue, ICT ran the NAPPSI Safety Device List. This article is part two of a look at how the National Alliance for the Primary Prevention of Sharps Related Injuries (NAPPSI) is assisting healthcare professionals in locating safety devices.
Since the early 1990s devices specifically designed to prevent sharps-related injuries have become increasingly common in healthcare. In fact, new concepts and emerging technology continue to increase both the type and volume of safety products available. The great variety of products now makes it possible to categorize them. The use of categories can make it faster and easier for clinicians to identify, evaluate and recommend safety product changes and additions for their facilities.
Understanding the Categories of Sharps Injury-Prevention Devices
The two broad categories are primary and secondary prevention. Secondary prevention devices were the first safety products available and remain vitally important in most safety programs. In secondary prevention devices, the needle or other sharp object is made safer through use of a recessed needle, blunting, retraction, or resheathing. The potentially dangerous object is not removed from use; rather, its use is made safer through product innovation.
In recent years, product design and new technology have introduced primary prevention devices. This category is significantly different from secondary prevention products. Primary prevention products either eliminate the need for the needle or sharp object completely or reduce the frequency with which the device must be used. For example, a surgical adhesive eliminates the use of suture needles in superficial closures. Catheter securement devices dramatically reduce the frequency with which peripheral intravenous catheters must be used and replaced.
The combination of both primary and secondary products increases the impact and potential risk reduction of safety programs. Yet many organizations remain unaware of primary prevention devices.
The NAPPSI Safety Device List
NAPPSI is a coalition of healthcare organizations, manufactures and clinicians committed to primary prevention advocacy and education. Founded in 1999, NAPPSI promotes the use of both primary and secondary devices in all safety programs.
To help accomplish this, NAPPSI has created a comprehensive Safety Device List that appears on the organization's Web site at http://www.nappsi.org/safety.shtml. The list includes many of the products that were originally identified by the Exposure Prevention Information Network, International Health Care Worker Safety Center (EPINet) at the University of Virginia. However, NAPPSI's list categorizes the approximately 200 products and manufacturers according to primary and secondary prevention. It is the only list of its kind to provide this categorical information. In addition, the NAPPSI Safety Device List is updated monthly, making it the most up-to-date resource for safety product information.
The NAPPSI Safety Device List is available at no charge to any interested individual. Unlike many other web resources, NAPPSI does not require users to register at its Web site. The list can be downloaded if a hard copy is needed.
Companies can add their devices to the NAPPSI; there is no fee for this service. Individuals interested in adding products should contact NAPPSI executive director Brad Poulos via email at firstname.lastname@example.org/.
The importance of NAPPSI's Safety Device List is being recognized by many organizations interested in healthcare safety. Among those who have added links to the NAPPSI site are the Centers for Disease Control and Prevention (CDC) and the Veterans Health Administration. Recently NAPPSI petitioned the Food and Drug Administration (FDA) and the Occupational Safety and Health Administration (OSHA) to add links to their Web sites. If you are a member of a professional organization concerned about safety, check to see if your organization has added or is planning to add a link to NAPPSI in 2003.
Tips for Using the Safety Device List
While there are endless possibilities for using the information contained in the list and every facility must ultimately decide which devices best meet it needs, NAPPSI has the following suggestions to get you started. Many of these topics are often overlooked in safety programs.
- Does your facility continue to suture central venous catheters? If so, remember that suture needles are the single cause of needlestick injuries. Sutureless securement devices today offer a successful, evidence-based, safer alternative. Physicians who place these catheters may not yet be familiar with them or may not have seen them in use. You can find information on sutureless catheter securement at NAPPSI's Web site and in the Safety Device List.
- If your facility has residents and interns, is their sharps-related injury rate verified? Are these physicians trained as aggressively as the rest of the staff? Studies show that the sharps-related injuries among interns and residents are seriously under-reported. The exact reason for this underreporting is not known. Most facilities have focused their training and compliance efforts at nurses. If your safety program needs to be refocused with more attention on physician awareness, the Safety Device List can help identify device alternatives doctors can and should use.
- How often does your facility replace peripheral catheters? If you do not know, then an analysis should be a priority in 2003. NAPPSI has reported that at least 50 percent of all peripheral IV catheters must be replaced. Every additional replacement increases the potential exposure of the physician or nurse to a needlestick injury. The NAPPSI Safety Device List can point you to products aimed at maximizing the dwell time of peripheral catheters and maximizing the safety of your overall infusion therapy program.
- Does your facility's diabetic management and education program include all of the newest needle-free options for care? If your program still relies on insulin syringes and non-safety finger lancing devices, you will find the newest products--including the latest generation of needle free injectors and laser lancets--at the NAAPSI list.
- Are the phlebotomy supplies all safety products? Do all clinicians use them? There are now safety alternatives for blood collection tubes, steel needles, butterfly needles, and sharps disposal containers. These products are often used in many areas or departments. Check to see if your facility has reviewed all products to evaluate safer alternatives and verified that safety products have been introduced to all potential users. Small departments and/or infrequent users can easily be overlooked. The NAPPSI list is an excellent resource to help keep everyone on track with your product updates.
- Once you start using the NAPPSI Safety Device List, you find that it helps keep you focused on safety products, supports identification of devices which need further evaluation and investigation, and stimulates creative problem solving for device-related dilemmas encountered at your facility. Remember, each organization must make targeted device selections based on the combined needs of its clinicians and patients. NAPPSI can help all facilities make the best possible choices for a safer healthcare environment.
Marilyn Hanchett, RN, is director of nursing at IgG America Inc. in Linthicum, Md. and is a national speaker for NAPPSI. She can be reached at email@example.com/.