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As part of its ongoing mission to eliminate needlestick and sharps injuries in healthcare, Safe in Common (SIC) has issued the "Top 10 Golden Rules of Safety."Â This set of guidelines was outlined in conjunction with supporters to unify the industry around efforts to fight needlestick injuries and raise awareness about effective prevention techniques.
The outline for the Top 10 Golden Rules of Safety was released at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC) in Ft. Lauderdale, Fla. earlier this month. The rules were met with resounding acceptance from members of the healthcare community who agree that more needs to be done, especially in the operating room and other high risk areas, to protect personnel.
The list is predicated on making injuries a "never event" and dictates that personnel using or purchasing sharps consider the following rules:
Â The design and activation of the safety mechanism is automatic and will not interfere with normal operating procedures and processes
Â The device is intuitive and requires no additional steps for use than equivalent standard/conventional device
Â The contaminated, non-sterile sharp will be rendered safe prior to removal or exposure to the environment
Â Activation of the safety mechanism does not require the healthcare worker to undertake any additional steps during normal process/protocols providing patient care
Â Activation of the safety mechanism will not create additional occupational hazards (such as aerosolization, splatter, exposure to OPIM, etc.)
Â Activation of the safety mechanism does not cause additional discomfort or harm to the patient
Â The device will be ergonomically designed for comfort, allowing for automatic one-handed use during all stages of patient procedure
Â The safer engineering control is available in sizes and iterations appropriate for all areas of use relevant to the patient care needs
Â Disposal of safety device will not increase waste disposal volumes but should incorporate designs to reduce waste
Â The used safety device will provide convenient disposal and mitigate any risk of reuse or re-exposure of the non-sterile sharp
"For the first time, the most experienced healthcare leaders have joined together to outline the rules for what it takes to keep all healthcare personnel safe and free of injury," says Barbara DeBaun, RN, MSN, CIC, improvement advisor for Cynosure HealthCare environments, who helped advise Safe in Common on these guidelines. "With these rules, we're getting the industry thinking about where we are and where we need to go to make safety a priority and injuries a never event."
To test the degree to which safety engineering controls have evolved, SIC evaluated whether the sharps devices on display at the conference were safe, simple and secure as outlined in the Golden Rules standards.
"Handwashing, surface disinfectant and devices designed to identify and eradicate bugs are prevalent, but there is lack of attention on devices aimed at healthcare worker safety and patient safety needs to prevent sharps injuries," says Safe in Common chairperson Mary Foley, PhD, RN. "It was disappointing that so few safety devices have emerged that protect the patient and healthcare worker before, during and after the use of the sharp."Â
SIC gauged attendees' opinions on safety devices during the event and found that, although the healthcare personnel in attendance at APIC generally accept the "safe, simple, secure" measures, the sharps devices currently available and on display meet the criteria outlined in the Golden Rules. OnlyÂ 9 percent of the 27 devices reviewed received a perfect 10 and exactly half had a passing grade of seven or higher. Some 41 percent had dismal scores of two to four.
Overall, the devices available at APIC scored well on two criteria:
Â The safer engineering control is available in sizes and iterations appropriate for all areas of use relevant to patient care needs (95 percent)
Â The used safety device will provide convenient disposal and mitigate any risk of reuse or re-exposure of the non-sterile sharp (86 percent)
Significant development effort remains against three essential criteria:
Â Activation of the safety mechanism does not require the healthcare worker to undertake any additional steps during normal processes providing patient care (32 percent)
Â The device is intuitive and requires no additional steps for use than equivalent standard or conventional devices (41 percent)
Â The contaminated, non-sterile sharp will be rendered safe prior to removal or exposure to the environment (48 percent)
Many of APIC's attendees are actively involved in device evaluation for healthcare use and consider products "as is" presented to them by industry sales representatives. SIC is measuring progress against a desired future or "should be" state. The gap explains why there has been considerable but incomplete progress in reducing percutaneous exposures to healthcare workers to roughly half of the levels estimated by the U.S. Centers for Disease Control and Prevention prior to enactment of the Needlestick Safety Act of 2000.
"For some, the glass is half full; for others, it is half empty. For those who have suffered a needlestick injury, it is broken," says Foley. "We understand the very personal trauma of exposure, both to patients and to personnel, who become patients themselves. We believe that occupational exposure should be a 'never event,' completely eliminated by superior engineering controls and education. Until we reach zero exposures to both patients and staff our agenda will remain unfinished."Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â
The "Top 10 Golden Rules" were also shared with some 800 healthcare leaders and personnel from across the globe who joined Safe in Common's panel of experts for "The Unfinished Agenda: When Will Healthcare Worker Sharps Injuries Become a Never Event?"Â
For more information about Safe in Common and the Organization's ongoing work to raise awareness of needlestick safety and promote utilizing safer engineering controls that protect healthcare workers from unnecessary needlestick- and sharps-related injuries, visit http://www.safeincommon.org
Source: Safe in Common