Creating a Positive Culture of Safety around Sharps Injury Prevention

1. Creating a Positive Culture of Safety around Sharps Injury Prevention

2. Culture of Safety: The product of individual and group: • Values • Attitudes • Perceptions • Competencies and • Patterns of behavior that determine commitment to and the style and proficiency of an organization’s health and safety management. (Reference: Sorra et al, AHRQ Pub No. 04-0041)

3. Safety Culture: • The shared values within an organization with regard to safety. • Expressed in the willingness to evaluate and learn from adverse events (References: Griffin & Neal, Journal of Occupational Health Psychology, 2000 Zhang, et al. Proceedings of the 46th Annual Meeting of the Human Factors and Ergonomics Society, 2002)

4. Safety Climate: • The shared perception, at a point in time, of the safety culture within an organization. • The degree to which employees feel that safety is an organizational value. (References: Griffin & Neal, Journal of Occupational Health Psychology, 2000 Zhang, et al. Proceedings of the 46th Annual Meeting of the Human Factors and Ergonomics Society, 2002)

5. Components of a Positive Culture of Safety: • Organizational commitment • Demonstrated at the highest levels in the organization • Management involvement • Commitment of resources • Employee empowerment • Freedom to voice concerns about hazards

6. Components of a Positive Culture of Safety: • Systems to acknowledge safe practices • Reporting systems • Injuries • Safe behaviors • Near misses • Hazards

7. Who’s involved? What’s their role? Management • Acknowledge positive behaviors • Allocate resources for new safety products and processes • Ensure that all staff are aware of and receive training when changes are made • Address suggestions made by staff to improve safety

8. Who’s involved? What’s their role? Staff • Acknowledge co-workers’ positive behaviors • Provide feedback to management on safety activities and new devices • Participate in training • Voice concerns about hazards to management • Offer solutions to identified hazards

9. Safety Culture and Sharps Injuries Nurses with a positive measure of safety culture more likely to accept newly introduced IV catheter safety device

10. Safety Culture and Sharps Injuries Measures of safety culture are associated with compliance with safe work practices Employees with higher measures of safety culture were half as likely to experience blood/body fluid exposure incidents

11. Activities specific to Sharps Injury Prevention • Engineering Controls • List of conventional devices identifying where they are used • Inventory of devices with safety features • Rigid sharps disposal containers • Training on the use of devices with safety features

12. Activities specific to sharps injury prevention (continued) • Sharps Injury Prevention Committee • Analysis and use of data in decision making • Process for identifying and reporting hazards • Process for reporting exposure incidents • Well developed post-exposure management protocols

13. Activities specific to sharps injury prevention (continued) • Bloodborne pathogen training • Upon hire and annually • Review of hazards, prevention measures and reporting protocols • Educational campaigns • In-services • Posters

14. Sharps Injury in the OR

15. Safety Culture Factors Long shifts Use of sharp suture needle Use of long length of suture material Unable to leave operating room Waiting until the end of the shift to report the exposure

16. Changes Shorter shifts to avoid fatigue Use of blunt suture needles Shorter suture material Identify someone in OR to call Occupational Health for exposures Triage exposure over the phone If necessary, Employee Health brings PEP to OR

17. Impact of positive changes: • Reduction of hazards with suture needles • reduction / elimination of injuries involving suture needles • Improved reporting • More timely post-exposure management • Improved employee safety and patient care

18. Culture of safety…. Together we can make it work! …the shared commitment of management and employees to ensure the safety of all care providers and patients in the facility.