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Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program


A-13 Device Evaluation Form

This form was developed to collect the opinions and observations of healthcare professionals regarding a device with an engineered sharps injury prevention feature. Use of this form will help healthcare organizations make final decisions about the acceptability of a product based on its usefulness and safety features.

This form is designed for use with multiple types of devices. Space is provided to insert product-specific questions that may be of special interest. Non-relevant questions can be removed (for example, questions regarding importance of hand size and whether the person is right- or left-handed).

To use this form for product evaluation, select staff who represent the scope of users who will use or handle the device. Decide on a reasonable testing period e.g., two to four weeks. Make sure staff are trained on the correct use of the device and encourage them to provide informal feedback during the evaluation period. Product evaluation forms should be completed and returned to the test coordinator as soon as possible after the evaluation period has ended. Note: not all questions will be applicable to all staff. If a question does not apply to a staff member's experience, the question should be left blank.

A sample letter to staff who will be completing the form is included. To gain accurate information and encourage participation from employees, emphasize that this is a confidential questionnaire and that the information provided will assist in determining the acceptability of this product.

In reviewing the completed forms, recognize that some items are more important than others. If necessary, meet with groups of workers who were involved with the evaluation to determine which criteria are most important to them. You will need to balance this feedback with the safety and practical considerations before determining whether or not to adopt the new device.

Tally questions by hand or computer to identify device-specific strengths and weaknesses. A form for summarizing responses is also included and provides a simple method for compiling the results. For more complex analyses, enter the responses into a data analysis program such as EpiInfo, Microsoft Excel, or SPSS for Windows.

Workbook Section Link for this Toolkit Product:
A-13 Worksheet (71 KB/3 pages) / A-13 Worksheet (94 KB/2 pages)

  Operational Processes
Selection of Sharps Injury Prevention Devices
Step 7. Develop a Product Evaluation Survey Form

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Publish date: February 12, 2004
This page last reviewed February 12, 2004