we have your back · current trends in sharps injuries and needlesticks wednesday, may 3, 2017 1....

We Have Your BackA Worker Safety Collaborative An Initiative of the Florida Hospital Association

WORKER SAFETY WEDNESDAY WEBINAR SERIES:

CURRENT TRENDS IN SHARPS INJURIES AND

NEEDLESTICKS

WEDNESDAY, MAY 3, 2017

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WELCOME!

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WHYB: Promoting workforce safety as an

organizational priority in our hospitals

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FOCUS AREAS:

Safe patient lifting, handling and mobility

Sharps injury and blood exposure prevention

Workplace violence

Finding solutions to reduce work stress, fatigue, and burnout

Special Thank You to Our

Sponsors!

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Current

Trends in

Sharps

Injuries and

Needlesticks

AMBER MITCHELL, DrPH,

MPH, CPH

PRESIDENT / EXECUTIVE DIRECTOR

INTERNATIONAL SAFETY

CENTER

HOUSTON, TEXAS

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OBJECTIVES

Re-define Parameters for WHYB Sharp Injury & Blood Exposure Prevention Bundle

Describe Current Trends Using EPINet Needlestick and Sharp Object Injury Summary Data

Provide Recommendations to Prevent Highest Frequency and100% Preventable Exposures

Identify If We Can Use Data to Build Prevention Bridges

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SHARP INJURY AND BLOOD EXPOSURE PREVENTION BUNDLE

§ Eliminate sharps whenever and wherever possible.

§ Utilize the hierarchy of controls, including engineering controls (safer medical devices), immediate disposal, and safe work practices to reduce sharps hazards.

§ Eliminate highest risk exposure practices in the operating room; use neutral zone passing of sharp devices and utilize eye protection for entire team.

§ Actively promote compliance with the utilization of safety devices and personal protective equipment.

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SHARP OBJECT & NEEDLESTICK INJURIES

EXPOSURE INCIDENT SUMMARY DATA

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~30 U.S. Hospitals & Health Systems____________Many Reporting to Aggregate since mid-1990s; Needlestick Safety & Prevention Act / OSHA BPS Champion Hospitals

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SUMMARY SHARP OBJECT INJURIES (SOI)

31.7 Injury Incident Reports / 100 Average Daily Census (ADC)

38.5 / 100 ADC; Teaching Facilities

19.9 / 100 ADC; Non-Teaching Facilities

24.7 Injury Incident Reports / 100 Average Daily Census (ADC)

27.2 / 100 ADC; Teaching Facilities

20.4 / 100 ADC; Non-Teaching Facilities

2015

2014

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PhysicianA ending

17%

PhysicianRes/Intern

7%Student1%

Nurse41%Phleb/IV

5%

Technical19%

EVS/Housekeep2%

SurgicalA end8%

SharpsInjuriesbyProfessionalGroup

Sharp Object injury & Needlestick Incident Summary Data,

N=30 US Health Systems

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DEVICE CAUSING INJURY FOR ALL

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Disposable Syringe

SutureScal…

Winged …

IV Stylet

Vacuum Tube w Needle

All Others

Other Needle

Pre-Filled …

Lancets

1%

Sharp Object injury & Needlestick Incident Summary Data 2015,

N=30 US Health Systems

DEVICE CAUSING INJURY FOR ALL

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Disposable Syringe

SutureScal…

Winged …

IV Stylet

Vacuum Tube w Needle

All Others

Other Needle

Pre-Filled …

Lancets

1% Employees Indicated

Safety Device Used

32.8%

Indicated Safety FeatureNot Activated

56.0%

Sharp Object injury & Needlestick Incident Summary Data 2015,

N=30 US Health Systems

LOCATION OF INJURY/EXPOSURE

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5

10

15

20

25

30

35

40

45

50

Patient Room OR/Recovery ED Clin Lab Outpt/Office Labor/Deliv ICU/CCU Service/Utili

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MOST FREQUENT INJURY BY PROFESSION

MD RN

Location OR Patient Room

Device Suture Disposable

Syringe

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International Safety Center – Do Not Disseminate

EPINet Report for Needlestick and Sharp Object Injuries 14 Other, describe 46 8.3% 16 Labor and delivery room 12 2.2% Total records: 555

7. Was the source patient identifiable? 1 Yes 527 94.8% 2 No 18 3.2% 3 Unknown 7 1.3% 4 N/A 4 0.7% Total records: 556

8. Was the injured worker the original user of the sharp item? 1 Yes 405 73.8% 2 No 136 24.8% 3 Unknown 3 0.5% 4 N/A 5 0.9% Total records: 549

9. The sharp item was: 1 Contaminated 498 90.4% 2 Uncontaminated 22 4.0% 3 Unknown 31 5.6% Total records: 551

10. For what purpose was the sharp item originally used? 1 Unknown/not applicable 17 3.1% 2 Injection, intramuscular/subcutaneous 175 31.5% 4 Other injection into IV injection site or port 6 1.1% 5 To connect IV line 2 0.4% 6 To start IV or setup heparin lock 21 3.8% 7 To draw a venous blood sample 55 9.9% 8 To draw an arterial blood sample 14 2.5% 9 To obtain a body fluid or tissue sample 6 1.1% 10 Fingerstick/heel stick 6 1.1% 11 Suturing 118 21.3% 12 Cutting 41 7.4% 13 Electrocautery 3 0.5% 15 Other, describe 77 13.9% 16 To place an arterial/central line 5 0.9% 17 Drilling 9 1.6% Total records: 555

11. Did the injury occur? 1 Before use of item 12 2.2% 2 During use of item 291 52.3%

Aug/07/2015 Page 2 of 5

1/4 of all injuries occurring downstream, outside of

the control of the user.

Injuries to EVS, waste haulers, laboratorians, and

fellow team members.

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HIGHEST PREVALENCE BY

PROCEDURE TYPE,2000-2011

Mitchell et al.

Journal of Hospital Infection,

2017

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SHARP OBJECT INJURY

SAFETY COMPARED TO NON-SAFETY,

2000-2011

Mitchell et al.

Journal of Hospital Infection,

2017

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BUILDING PREVENTION STRATEGIES

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PREVENTING NEEDLESTICKS & SHARPS INJURIES

Ditch the Pinch Bilateral exposure injuries during subcutaneous injection

Selecting Correct Size and Gauge Needle Am J Infect Control. 2013

Employee Evaluation & Feedback, Safer Devices Improving Safety Device Activation

Eliminating Downstream Injuries Safety Device Activation

Improving Disposal Practices

Eliminating Needle Transfer from Syringe to Blood Tube

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DISPOSABLE NEEDLE SIZEEvaluate Needle Usage,

”Gauge”

Appropriateness of Size

Selection

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Safety devices are evaluated and selected by non-managerial frontline employees

Improve use of safety devices

Improve activation of safety feature

Decrease downstream, non-user injuries

Create culture and climate of safety

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IMPORTANCE OF FRONTLINE EMPLOYEE FEEDBACK

EMPLOYEE EVALUATION & SAFETY FEATURE ACTIVATION

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Safety Feature Activation Safety throughout the life of the device

Provide Feedback from Employees to Manufacturer/Distributor/Purchasing

WHO,

2003

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NON-USER DOWNSTREAM INJURIES

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PREVENTING DOWNSTREAM

INJURIES: ADAPTING

COMMUNITY MODELS

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INJURIES FROM BLOOD

COLLECTION ONLY Disposable

Syringe

Blood GasNeedle on

IV

Winged

Steel

IV Stylet

Vacuum

Tube w

Needle

Other

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PREVENTING INJURIES FROM BLOOD TRANSFER

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USING DATA TO BUILD PREVENTION BRIDGES

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THE INJURY OCCURRED…

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…SO TO PREVENT IT, WE MUST…?

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THANK YOU!Amber.Mitchell@

InternationalSafetyCenter.org

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Questions?

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Sharps Injury and Blood

Exposure Prevention Events

June 7 – Strategies to Improve PPE Placement, Use and

Compliance

July 12 – WHYB Education Roundtable

FHA Corporate Office, Orlando, Florida

September 6 – Sharps Injury and Blood Exposure Prevention

September 19-20 – WHYB Worker Safety Annual Conference

The Westin Lake Mary, Lake Mary, Florida

Details and Registration at: http://www.fha.org/health-care-

issues/workforce.aspx

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Webinar Evaluation Survey &

Continuing Nursing Education

Eligibility for Nursing CEU requires submission of an evaluation survey for each participant requesting continuing education:https://www.surveymonkey.com/r/QH3GH3S

Share this link with all of your participants if viewing today’s webinar as a group

Be sure to include your contact information and Florida nursing license number

FHA will report 1.0 credit hour to CE Broker and a certificate will be sent via e-mail

We would appreciate your feedback even if you are not applying for CEUs!!

Web participants can stay logged in as the webinarcloses to be redirected to the online survey (the linkwill also be provided in a follow up email)

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THANK YOU!

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WHYB Questions and

Information –

407-841-6230

whyb@fha.org

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An Initiative of the Florida Hospital Association