Legislating Safe Sharps Compliance? .Yeah, Right

Edition: September 2001 - Vol 9 Number 09
Article#: 1051
Author: Dr. Sheila Dunn

Why aren't all of your customers grateful that OSHA came along and passed a law to protect them from dreaded diseases like HIV and hepatitis? Why don't they welcome the new legislation and use these new items religiously? Suffice it to say that in most health care settings, safety is still a concept that just hasn't caught on.

Sound familiar?

•A billing supervisor stores a large bowl of potato salad, to be served at a potluck lunch in the same refrigerator where blood specimens are kept.

•A medical assistant drinks an ice-cold soda while processing patient blood specimens.

•A nurse sifts through a red biohazardous waste bag with bare hands looking for a discarded item.

•A physician rinses a flexible sigmoidoscope in a sink without wearing protective facewear.

Ah, the good old days, right? Not hardly. All of these events occurred last month, and I witnessed them first-hand. I don't think for one minute that these are isolated events at just one workplace. I'd bet my bottom dollar that they unfold in alarming numbers at a multitude of facilities; most of the time when someone with authority isn't looking.

Why do intelligent people flagrantly disregard their own safety? Because, you can't legislate compliance. Oh sure, you can punish non-compliance, but that only works when offenders get caught and it only works because they don't want to get caught again, not because it's a good idea. Those of you with children understand this concept perfectly, I'll bet!

When people don't take risk seriously, they'll find ways and opportunities to circumvent every regulation ever enacted when the opportunity to get away with it presents itself. Anyone heard of the medical practice that buys one box of safety needles to sit on the shelf, only to be used when an OSHA inspector shows up???

When employers fail to protect workers – whether it's failing to provide safety sharps or whether it's non disciplining passively suicidal employees who won't wear gloves or for failing to warn brainless consumers that coffee is hot-it's the employers' fault. These employers will face monetary (and sometimes criminal) charges, so they might just as well get out their wallets now, rather than later.

For these reasons, we expect safety needle legislation to reduce accidental needlesticks, but at a disappointing rate. Why? Because far too many employers will fail to provide safety devices and in those facilities that do, health care workers will willingly circumvent change, even if change is designed to let them grow old and become a burden to their children.

Once your accounts get converted to safety devices, expect to see workers dismantling safety features on needles or not activating them at all. Don't expect safety needle legislation to be the end of necessary intervention. Equipment is only half the solution; constant follow-up by practice management must follow to minimize sharps accidents.

We're talking the kind of management Sister Alphonsus, my 2nd-grade nun, applied to my knuckles day in and day out. If Sister Alphonsus was alive today and knew about the Bloodborne Pathogen Standard, she'd hang you by your lips until recess was over if she caught you drawing blood without gloves. I hate to think what she'd do if that was your potato salad in the lab fridge. Sister Alphonsus could accomplish in a day what OSHA couldn't do in a generation.

ABOUT THE AUTHOR: Dr. Sheila Dunn heads Quality America, Inc., an Asheville, NC based consulting firm that publishes an OSHA Safety Manual, video, and newsletter. Quality America's newest product is a Sharps Injury Reduction Program video. All products are sold through distribution. For information about Quality America's products ans services, call 800-946-9956, or visit Quality America's OnLine Resource Center @ www.quality-america.com.