By Diana Baranowsky, RN, BSN, MS, CIC
The Needlestick Safety and Prevention Act, which becameeffective April 18, 2001, mandates important changes to the Bloodborne PathogenStandard issued by the Occupational Safety and Health Administration (OSHA).Compliance with these new regulations helps OSHA and employers achieve a goal ofmaking the workplace safer for healthcare workers (HCWs).
By issuing a sentinel event alert in August 2001 requiringcompliance with this OSHA act, the Joint Commission on the Accreditation ofHealthcare Organizations (JCAHO) likewise reinforced its collaboration toprotect HCWs and patients. The techniques that are used to protect HCWs fromneedlestick can also protect patients. The existing Bloodborne Pathogen Standardestablished in 1991 required the use of safety-engineered sharps and need-lesssystems whenever possible. The new act strengthens and broadens this standardwith its requirement of selecting and implementing safer needle devices as theybecome available, involvement of non-managerial frontline workers in evaluatingand selecting safety engineered devices, and maintaining a sharps injury logwhich contains at a minimum the type and brand of device involved in a needlestick injury and a description of the incident.
Even prior to the act, the Stamford Hospital in Stamford,Conn., had established a Safety (Needle) Device Task Force to set priorities andstrategies for prevention of needlesticks among its HCWs. Staff from the centralprocessing (CP) department was an integral part of this team. Under thedirection of the infection control committee, this multidisciplinary task forceencouraged HCWs to report needlestick injuries and any needlestick hazards theyobserved in the work environment. It analyzed and trendedneedlestick/sharps-related injuries, and involved frontline HCWs in theselection and evaluation of devices with safety features. It also evaluated theeffectiveness of its prevention efforts.
A valuable asset to the current task force is the input itreceives from CP employees. As an infection control nurse, I have alwaysrecognized and valued the efforts of CP and its tremendous impact on patientsafety. Now, as chairperson of the task force, I see an even greater dimensionof the responsibilities of CPtheir commitment to the safety of theircustomers, their peers and other HCWs. This facet seems to flourish in supportof the task forces commitment to comply with the new standards.
Traditionally, CP has been meeting the clinical needs of theoperating room (OR) and surgical staff as well as the needs of direct patientcare staff. By soliciting the input of CP workers regarding work practices anddevices that pose injury hazards, this staff accepted empowerment to grow and tothink outside of the box in order to identify and solve problems.
When the task force was discussing the evaluation of safetydisposable scalpels in the OR, CP recommended that they proceed with the removalof the reprocessed blade handles from the kits which they assemble (i.e.,circumcision tray, pacemaker wire insertion tray) and replacing them with safetydisposable scalpels facility-wide. The Stamford Hospital CP staff thought interms of system issues when they took the initiative to explore safety needledevices, which could be autoclaved in order to accommodate the emergencydepartment (ED) physicians whose work practices are to have a needle includedinside the sterile suture kit. These are examples of how the support and inputof CP employees can ensure a sharps injury prevention environment.
CP individuals have also been involved with the task forceefforts to improve the safety of our hospitals healthcare practice issues. Itwas CP who recommended that Llabor and delivery nursing staff pilot the P-2Safety Plus gloves used in CP for that staffs use during post-deliverycleanup. Through their input to the task force, CP personnel are promotingcollaborative partnerships in the workplace.
This is the approach they have been using all along when theywork closely with teams from other disciplines such as anesthesiology andrespiratory therapy on a regular basis.
It is evident by their commitment to an injury-preventionmodel that CP personnel know that their contribution to their customers and asafe environment makes a difference. I have highlighted just a few of theinitiatives of the CP frontline HCWs; I am confident that this is just thebeginning.
Diana Baranowsky, RN, BSN, MS, CIC is the nurse epidemiologistat Stamford Hospital in Stamford, Conn.