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An article published in the Spring 2014 issue of the Journal of the Association of Occupational Health Professionals in Healthcare discusses how a systematic, data-driven approach and the subsequent adoption of a safety-engineered blood collection set helped Robert Wood Johnson University Hospital (RWJUH), a leading academic medical center, reduce needlestick injuries (NSIs) by nearly 70 percent among its patient care technicians and nursing staff.
In the article, "Successfully Reducing Wingset-related Needlestick Injuries," author Doris L. Dicristina, RN, BSN, MS, COHN-S/CM, director of employee health and wellness services for RWJUH, reports how her team identified that forward-shielding safety blood collection sets accounted for 30 percent of the institution's NSIs in 2010 and 43 percent in 2011.
The financial impact of these NSIs on RWJUH ranged from $400-$6,000 per injury, depending on whether the patient was known to carry a bloodborne disease such as hepatitis C, hepatitis B or HIV/AIDS. Using a novel financial model, RWJUH estimated that it would need to generate more than $106,000 in additional revenue to cover the cost of each NSI from a source-negative patient, with injuries from source-positive patients costing even more.
"Our first instinct in 2010 was to retrain...," Dicristina wrote. "It became clear that retraining – although important – was not the solution, and that the current engineering control was in fact the problem."
Further investigation revealed that approximately 83 percent of injuries with the forward-shielding safety blood collection sets occurred after clinicians removed the needles from their patients' veins, but before they activated the safety mechanism. After an extensive search and evaluation of different safety blood collection sets, the hospital selected the BD Vacutainer® Push Button Blood Collection Set (PBBCS), with a split-second retracting needle that offers in-vein safety activation.
The study reports that, after staff training and full conversion to the new safety device, NSIs at RWJUH dropped nearly 70 percent from 45 injuries in 2010 and 2011 to 14 in 2012 and 2013. The injury rate per 100,000 devices purchased fell more than 64 percent – from 7.43 in 2010-2011 to 2.65 in 2012-2013.
"This case study shows how having the right engineering control, along with commitment from all levels of an organization, can help achieve and sustain dramatic reductions in needlestick injuries," says Ana K. Stankovic, MD, PhD, MSPH, worldwide vice president of medical affairs for BD Diagnostics – Preanalytical Systems.
"Part of a strong organizational and institutional safety culture is the willingness to take a systematic, data-driven approach to investigating and addressing these issues," Dicristina says. "Despite the increase in device cost, RWJUH elected to do what is right for the clinicians who perform the procedures in question and live with their associated risks every day. Protecting and saving their lives was the focus, and, RWJUH is now beginning to see the cost savings."