Sharps injuries among hospital workers in Massachusetts, 2009: findings from the Massachusetts Sharps Injury Surveillance System.
Laramie AK; Davis LK; Pun VC; Laing J; DeMaria A Jr.
Boston, MA: Massachusetts Department of Public Health, 2011 Mar; :1-23
In 2009, close to 2,900 sharps injuries were reported in Massachusetts hospitals, underscoring the need for continued efforts to reduce the incidence of these injuries. An unacceptably high number of injuries continue to occur with devices lacking sharps injury prevention features, most notably hypodermic needles/syringes for which alternatives with sharps injury prevention features have been available for two decades. Hospitals are reminded that MDPH regulations require that sharps injury prevention technology must be used in the provision of care to patients, an inventory of devices lacking sharps injury prevention features must be developed and justification of the continued use of devices lacking sharps injury prevention features must be documented. Hospitals must use Annual Summary data as part of continuous quality control. This data can be used to identify devices to review, or departments where injuries are occurring. Key steps to take in developing a device inventory and converting devices to those with sharps injury prevention features are outlined below. Resources for identifying devices with sharps injury prevention features are also provided. 1. Know what is being used within the hospital. MDPH requires hospitals to complete an inventory of devices lacking sharps injury prevention features. This requirement was outlined in a circular letter to all hospitals in May of 2009. Developing an inventory is a substantial undertaking, and should be a team effort. Some hospitals have found it to be more efficient to ask staff in various departments to complete the inventory for the devices they use. This not only shares the responsibility, but also involves staff in the process and raises awareness of sharps injury prevention. 2. Identify those devices that can be converted to alternatives with sharps injury prevention features. a. Using the inventory list, distinguish those items that have alternatives available on the market from those that do not b. If hospitals have questions regarding the availability of alternatives with sharps injury prevention features for specific devices, OHSP can distribute these questions in monthly emails to MDPH licensed hospitals c. Information regarding devices with sharps injury prevention features can be found on our website under i. Sustainable Hospitals Project - Safety Needles and Sharps Devices; ii. International Sharps Injury Prevention Society; and iii. International Healthcare Worker Safety Center - Safety Device List. 3. Develop a plan for converting devices. Due to the scope of the project - both the number and variety of devices - the device conversion process can not be completed all at one time. Annual Summary data can be used to prioritize the order of devices to convert. If your hospital does not have many reported injuries in a year, you can aggregate data over several years (3-5 years) or use the statewide data in this prioritization process. Things to consider when prioritizing devices to convert: 1. frequency of use; 2. number of injuries which have occurred with this device; an 3. risk of transmission of disease given procedures for which the device is used. 4. Complete the waiver process. MDPH requires documentation justifying the continued use of devices lacking sharps injury prevention features, as outlined in the circular letter of May 2009. These waivers must be completed and reviewed by an internal committee, and approved by the hospital and shall be made available to MDPH upon request. These waivers should be reviewed annually to see if they are still applicable. As with the device inventory, some hospitals have found it more efficient to enlist the help of staff in completing the waivers for devices used in their department. Waiver forms are available upon request from MDPH-OHSP. Waivers must be completed for: i. Those devices for which alternatives exist, but it has been determined by an internal committee that the device does not promote employee or patient safety or interferes with a medical procedure; and ii. Those devices for which no alternative exists on the market. 5. Develop a plan for continued review of devices. On a regular, periodic basis (at least annually), the device inventory should be reviewed to see if there are new device alternatives available with sharps injury prevention features. A sharps committee or product analysis committee could conduct such reviews; it may also be useful to involve the departments where devices lacking sharps injury prevention features are used. This process should be reflected in the Exposure Control Plan. At least annually, the Exposure Control Plan shall be updated to reflect any new technology implemented to minimize risk of exposure. The Exposure Control Plan shall also document consideration of new devices and solicitation of input from non-managerial workers regarding these new devices. Hospitals are reminded to report any issues with devices to product manufacturers, and, if appropriate, the FDA. Information on reporting device failures and serious adverse events was included in the previous report "Sharps Injuries among Hospital Workers in Massachusetts, 2008: Findings from the Massachusetts Sharps Injury Surveillance System." While use of devices with sharps injury prevention features has been demonstrated to reduce sharps injuries, it is just one component of a comprehensive sharps injury prevention program. Training on the use of these devices is critical for all employees. In addition, there needs to be an increased understanding of the relative efficacy of the various mechanisms of sharps injury prevention features. In 2010, the mechanism of the sharps injury prevention feature was added to the Annual Summary of Sharps Injuries. Information on the mechanisms of the sharps injury prevention feature will be available in future reports.
Health-care-personnel; Medical-personnel; Exposure-levels; Needlestick-injuries; Public-health; Hazards; Nurses; Nursing; Workers; Health-care-facilities; Health-care; Preventive-medicine; Safety-practices; Safety-measures; Safety-education; Training; Disease-prevention; Disease-transmission; Disease-control; Work-practices; Worker-health; Surveillance-programs; Employee-exposure; Statistical-analysis
Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research and Evaluation, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108
Sharps injuries among hospital workers in Massachusetts, 2009: findings from the Massachusetts Sharps Injury Surveillance System
Massachusetts State Department of Public Health - Boston