we have your back · current trends in sharps injuries and needlesticks wednesday, may 3, 2017 1....
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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
0
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
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Share this link with all of your participants if viewing today’s webinar as a group
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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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An Initiative of the Florida Hospital Association