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EXPO-S.T.O.P. 2016 & 2017 Exposure Benchmark Research

EXPO-S.T.O.P. 2016 & 2017 Exposure Benchmark Research. Terry Grimmond , FASM, BAgrSc, GrDpAdEd Linda Good , PhD, RN, COHN-S. AOHP Webinar Presentation, March 7, 2019. Learning Objectives.

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EXPO-S.T.O.P. 2016 & 2017 Exposure Benchmark Research

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  1. EXPO-S.T.O.P. 2016 & 2017 Exposure Benchmark Research Terry Grimmond, FASM, BAgrSc, GrDpAdEd Linda Good, PhD, RN, COHN-S AOHP Webinar Presentation, March 7, 2019

  2. Learning Objectives • Review SI history, & 2016 & 2017 EXPO-S.T.O.P.* surveys *Exposure Survey of Trends in Occupational Practice • Identify the urgent need to halt the rising SI rate • Identify best practices in reducing blood exposures

  3. Why EXPO-S.T.O.P. Survey? • Good databases existed (EPINet, MSISS) but none national • AOHP members could provide a nationwide database • AOHPEXPO-STOP survey commenced to raise awareness

  4. EXPO-STOP Publications

  5. Using “Occ Beds” gives “Significant SI increase” 2001 – 2016 SI Per 100 ADC

  6. Sharps Injury Rates per FTE -38% SI per 100 FTE -15%

  7. EXPO-S.T.O.P 2011-2017 50% Teaching

  8. EXPO-STOP: SI rates * Significant

  9. SI Rate – by Hosp SIZE using “FTE-size” “High-Low-Higher” SI per 100 FTE * Significant Size by Total FTE

  10. EXPO-STOP: Nurse SI rates / 100 Nurse FTE * Significant NB. Only 60% of hospitals could supply nurse exposure data

  11. EXPO-STOP Annual Trends: Who gets stuck?

  12. EXPO-STOP Annual Trends: Mucocutaneous * Significant difference from value in immediate column to left; ** significantly different from 2011

  13. Using “Occ Beds” gives “Significant SI increase” 2001 – 2017 SI Per 100 ADC

  14. Sharps Injury Rates per FTE -38% -7% SI per 100 FTE

  15. Lessons-Learned from “Exposure Safe” Hospitals • Leadership Support: Essential for tough policy/tough calls • Education & Training • Communication • Investigation • Engagement • Good L, Grimmond T. Proven Strategies to Prevent Bloodborne Pathogen Exposure in EXPO-S.T.O.P. Hospitals. JAOHP 2017:36(1);1-5. • Good L, et al. Exposure Injury Reduction Strategies: Results that Protect Lives. JAOHP 2018;38(4):10-13

  16. Education & Training “What worked is a lot of EDUCATION” • Don’t assume new staff “know” your policies, rules, SED. • Staff need demonstrate competency with relevant SED – incl Drs. • Sign-off on “completion & understanding”. e.g. policies, practices, reporting procedures, unauthorized SED use. • Return for coaching/complete a module if: SI, new SED, every 2 yrs. • Simulation lab; All staff/shifts; use vendors.

  17. Communication “We make monthly Blood Exposure Numbers transparent to ALL staff.” Make reporting convenient; 24/7 phone (share costs with other hosp) Awareness campaigns - keep BE at forefront. e.g. “Go Slow with Sharps”; “Face Shield is the New Glove”, Monthly bulletins; cafeteria stands. Find “safety champ” in unit. e.g. surgeon/anesthetist in OR “Our phlebotomists recite “safety script” to patient - “I need you to hold still for 30sec for your safety and mine” “We use a patient-door sign ‘Sharps Procedure in progress’.”

  18. Investigation • Encourage reporting of every Exp. “No blame No shame” • With injured staff, discuss every incident’s root-cause: Ask their opinion – “How could this have been prevented?; “Was SED available?”, “Did you use SED?”, “Did you activate it?” • Annually review safer SED availability (it’s OSHA law). “We dropped to zero insulin SI after changing to retractables”. • If poor practice discovered, ask Manager to discuss at staff mtg. • “We dismissed a Dr after 3 SI in one yr – he ignored policy 3 times.”

  19. Engagement • “We hold frontline staff & managers responsible for their safety.” • When staff do well, get senior leadership to praise them “Employees who perceived strong senior leadership support for safety and who received high levels of safety-related feedback and training were half as likely to experience blood or body fluid exposure incidents.” Gershon et al AJIC 2000;28:211-21 • Hold Safety Forums; start with a though-provoking: “If your workplace was a safer environment, what would it look like?” • “Commitment to ‘Neutral Zone’ by the whole surgical team was key to bringing down exposures in our OR.”

  20. SUMMARY • SI rates have risen for last 3 years • Effective interventions are urgently needed • We need be aggressive and relentless in our efforts

  21. Your data CREATES EXPO-STOP ThankYou!!

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