Infection Control Today - 05/2002: Sharps Safety

May 1, 2002

Infection Control Today

Infection Control Today magazines virtual roundtable onsharps safety

Becton Dickinson
1 Becton Drive
Franklin Lakes, NJ 07417
(201) 847.6800
www.bd.com

Infection Control Today: While the Needlestick Safety and Prevention Actof 2000 helped raise awareness of sharps injuries among healthcare workers, doyou think this legislation had a quantifiable impact on reducing incidencesoverall?

Becton Dickinson: It is too early to evaluate the full impact thatsafety-engineered devices will eventually play in keeping healthcare workerssafer from exposure to hazardous bloodborne pathogens. We do know from clinicalstudies conducted in the past that the use of safety-engineered devices overtime significantly reduces the number of sharps injuries sustained by healthcareworkers. The passing of this important federal law has served to promote thesefindings and compel safer practices including 1) documentation in an exposurecontrol plan that safer needle devices are being evaluated and implemented; 2)the inclusion of non-managerial frontline workers in choosing safer devices and3) the requirement that all facilities establish and maintain a sharps injurylog.

Infection Control Today: What can be done in hospitals to realisticallysafeguard healthcare workers from sharps injuries?

Becton Dickinson: BD has created a simple five-step plan to assist healthcarefacilities to comply to the new legislation and to help reduce sharps relatedinjuries:

Step 1: Understand Before any safety actions within a facility canoccur, it is important for healthcare workers to understand the new governmentactions. A multi-disciplinary team should be established to research and gatherthe necessary information. This team can assume responsibility for guiding anddirecting the overall safety initiatives.

Step 2: Assess In this step an institution should asses current sharpssafety policies and practices relative to the government regulations andidentify gaps to compliance. Based on this self-assessment, priorities forenacting safety measures may be established.

Step 3: Review After identifying areas for improvement, the facilityshould explore and evaluate potential solutions, including the range ofcommercially available safety-engineered medical devices to meet that facility'sneeds.

Step 4: Implement Once the first three steps are completed, the newprocess and products can be put into place. In order to best facilitateimplementation, healthcare workers should be trained in the correct usage ofdevices, and criteria should be established to ensure both quality patient careand healthcare worker safety.

Step 5: Measure To ensure success and to promote continuousimprovement, steps should be taken to measure the program's results. The programmay be evaluated by monitoring the use of the new devices, soliciting feedbackfrom healthcare workers and determining if additional training might benecessary.

Infection Control Today: As a manufacturer, how are you able to betterengineer sharps to help mitigate or eradicate the possibility of occupationalexposure?

Becton Dickinson: BD is committed to healthcare worker safety and continuallyacts to improve current technology in response to customer needs. BD also holdsthe most patents among medical device manufacturers today and has spentapproximately 500 million dollars in research and development and to increaseproduction of our safety-engineered devices.

Infection Control Today: The most effectively designed sharps safetydevice won't do its job unless healthcare workers know how to use it properly.What kind of staff education and training would you advocate?

Becton Dickinson: The Needlestick Safety and Prevention ACT and the updatedOccupational Safety and Health Administration (OSHA) Bloodborne PathogenStandard require not only work practice controls, but a training program to beimplemented as well. While BD has made every effort to develop and introducesafety-engineered devices to minimize any change in technique for the user, itis important for a healthcare worker to be adequately trained on the use of anynew safety device. BD, again, is committed to making the transition to safety aneasier one for our customers and we offer on-going inservice training tohospital staff members going through the process of implementing our safetyproducts. BD sales representatives are trained and ready to assist in the properuse and activation of our devices and to supply the necessary training supportliterature and materials.

Infection Control Today: What should a healthcare worker look for whenevaluating a sharps safety device for use?

Becton Dickinson: The National Institute for Occupational Safety and Health(NIOSH) has published a list of useful criteria for the evaluation of safetydevices. The criteria was developed by a number of sources including OSHA, theFDA, Janine Jagger of the Health Care Worker Safety Center at the University ofVirginia, and other opinion leaders. These characteristics were compiled andpublished in the NIOSH Alert titled, Preventing Needlestick Injuries inHealth care Settings. Ultimately, each facility needs to determine what willbe most effective in reducing accidental needlesticks in their individualsituation.

Infection Control Today: What would you say to the hospital administrator whobalks at the cost of exchanging conventional sharps for protective devices?

Becton Dickinson: The cost of a single needlestick injury sustained by ahealthcare employee can be far greater than implementing safety-engineereddevices system-wide.

According to the American Hospital Association, one case of serious infectionby bloodborne pathogens can soon add up to $1 million dollars or more inexpenditures for testing follow-up, lost time and disability payments. And, thecost of follow-up for a high risk exposure is almost $3,000 per needlestickinjury even when no infection occurs.