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Part I: Background

Preventing Needlesticks and Other Sharps Injuries… Everything You Need to Know. Part I: Background. Part I: Background Part II: Safer Sharps Devices Part III: Safe Work Practices. The Problem.

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Part I: Background

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  1. Preventing Needlesticks and Other Sharps Injuries…Everything You Need to Know Part I: Background

  2. Part I: Background • Part II: Safer Sharps Devices • Part III: Safe Work Practices

  3. The Problem • CDC estimates ~385,000 sharps injuries annually among hospital-based healthcare personnel (>1,000 injuries/day) • Many more in other healthcare settings (e.g., emergency services, home care, nursing homes) • Increased risk for bloodborne virus transmission • Costly to personnel and healthcare system

  4. Risks of Seroconversion due to Sharps Injury from a known positive source Virus HBV HCV HIV Risk (Range) 6-30%* ~ 2% 0.3% (*Risk for HBV applies if not HB vaccinated)

  5. What is the Risk for HIV Alone? • Percutaneous 0.3% • Mucous membrane 0.1% • Non-intact skin <0.1%

  6. Occupational HIV Transmission among U.S. Healthcare Personnel, 1985-2004 • 57 documented cases • i.e., HIV negative at time of exposure and became HIV positive during follow-up period • 137 other cases • i.e., No documented exposure and no known risk factor for HIV infection

  7. Occupational HIV TransmissionDocumented Cases (n=57) • 50 (88%) involved percutaneous exposures 45 caused by hollow-bore needles, half of which were used in a vein or artery • 5 mucocutaneous exposures • 2 exposure route unknown

  8. Costs of Sharps Injuries • Baseline and follow-up laboratory testing • Treatment of exposed personnel • $71-~$5,000 depending on treatment provided • Lost productivity • Time to complete paperwork • Loss of income / loss of career • Emotional costs • Societal costs O’Malley, et. al. Costs of Management of Occupational Exposure to Blood and Body Fluids. ICHE, July 2007, v 28, No. 7.

  9. Preventing Sharps Injuries is Our Goal!

  10. How Do Sharps Injuries Happen? • Who gets injured? • Where do they happen? • When do injuries occur? • What devices are involved? • How can they be prevented?

  11. Data Sources • National Surveillance System for Healthcare Workers (NaSH) • Exposure Prevention Information Network (EPINet™)

  12. Who Gets Injured? Occupational Groups of Healthcare Personnel Exposed to Blood/Body Fluids, NaSH June 1995—December 2003 (n=23,197)

  13. Where Do Sharps Injuries Occur? • Patient Room 39% (Inpatient: Medical – ICUs ) • Operating Room 27% • Outpatient 8% • ER 8% • Laboratory 5% • Other 13% Source: NaSH, June 1995—December 2003

  14. When Do Sharps Injuries Occur? • During use 41% • After use/before disposal 40% • During and after disposal 15% • Other 4% Source: NaSH, June 1995—December 2003

  15. What Devices are Involved in Sharps Injuries? Six Devices Account for 78% of All Injuries • Disposable Syringes 30% • Suture Needles 20% • Winged-Steel Needles 12% • Intravenous Catheter Stylets 5% • Phlebotomy Needles 3% • Scalpels 8% Source: NaSH, June 1995—December 2003

  16. Devices that Require Manipulation after Use are Associated with an Increased Rate of Injury Jagger, et al. Rates of needle-stick injury caused by various devices in a university hospital. NEJM. 1988;319.

  17. How Do Injuries Occur With Hollow-Bore Needles? Circumstances Associated with Hollow-Bore Needle Injuries NaSH June 1995—December 2003 (n=10,239) Disposal Related: 35%

  18. Sharps Injuries Are Preventable Preventability of Needlesticks in 78 NaSH Hospitals, June 1995--December 2004 (n=11,625)

  19. Preventing Sharps Injuries is a National Priority! • Federal and state laws increase enforcement of sharps injury prevention • Needlestick Safety and Prevention Act, 2000 • OSHA enforcement of needlestick prevention increasing • 21 states with laws/regulations • CDC: targets needlesticks for elimination

  20. Sharps Injuries at ______Hospital (period of time) • Last year _____ sharps injuries were reported by our employees/staff • The occupations most affected were _____ • The devices most commonly involved were _____ • The most common ways sharps injuries occurred were _____

  21. What are Strategies to Eliminate Sharps Injuries? • Eliminate or reduce the use of needles and other sharps • Use devices with safety features to isolate sharps • Use safer practices to minimize risk for remaining hazards

  22. Part II: Safer Sharps Devices Part III: Safe Work Practices

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