Needlestick Assessments to Begin in April
Edition: October 2001 - Vol 9 Number 10
The Joint Commission on Accreditation of Healthcare Organizations said it will begin assessing providers' compliance with the Needlestick Safety and Prevention Act in April 2002. The Oakbrook Terrace, IL-based organization issued a Sentinel Event Alert to increase providers' understanding of the hazards of needlesticks as well as the requirements of the law, which was signed by former President Clinton on Nov. 6, 2000, and which took effect July 17, 2001.
The law specifies the types of engineering controls, such as safer medical devices, in the health care setting and adds new requirements for employers. Employers must:
Review their exposure control plans annually to reflect changes in technology that will help eliminate or reduce exposure to bloodborne pathogens.
Involve non-managerial workers in evaluating and selecting safety-engineered devices.
Maintain a sharps injury log that ensures employee privacy and contains, at a minimum, the type and brand of device involved in the incident, if known; the location of the incident; and a description of the incident.
The Centers for Disease Control and Prevention estimates that each year, health care workers sustain more than 600,000 injuries involving contaminated needles or sharps, and approximately one-half of these injuries go unreported. While most needlestick injuries involve nursing staff, other health care workers also sustain injuries. Injuries involving patients are less frequent. The Joint Commission's sentinel event database includes two cases--one involving an infant and one a child.
The risk of infection from a contaminated needlestick or sharp is dependent upon the pathogen involved, the severity of the injury, and the availability and use of appropriate prophylactic treatment, says JCAHO. Hollow-bore needles -- primarily hypodermic needles attached to disposable syringes and winged-steel or butterfly-type needles -- are the cause of the majority of reported injuries. Injuries can occur while manipulating the needle in the patient, handling or passing the device after it has been used, recapping the instrument, and transferring a body fluid between containers, or from improper disposal or during clean-up following a procedure.
All health care organizations should have a needlestick prevention program in place as part of their compliance with the existing bloodborne pathogen standard established in 1991 by OSHA, which requires organizations to use safety-engineered sharps and needleless systems when possible. In addition, in its Preventing Needlestick Injuries in Health Care Settings publication, the National Institute for Occupational Safety and Health outlines a number of strategies to help prevent needlestick and sharps injuries:
Eliminate the use of needles when safe and effective alternatives are available.
Implement the use of devices with safety features and evaluate their use to determine which are most effective and acceptable.
Analyze needlestick- and sharps-related injuries in your workplace to identify hazards and injury trends.
Set priorities and strategies for prevention by examining local and national information about risk factors for needlestick injuries and successful intervention efforts.
Ensure that health care workers are properly trained in the safe use and disposal of needles and sharps.
Modify work practices that pose a needlestick injury hazard to make them safer.
Establish procedures for and encourage the reporting and timely follow-up of all needlestick and other sharps-related injuries.
Evaluate the effectiveness of prevention efforts and provide feedback on performance.
Encourage health care workers to report any hazards from needles they observe in their work environment and to participate in bloodborne pathogen training and follow recommended injury prevention practices, including getting a hepatitis B vaccination.