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Making a Sharp Example Lisa J .Prescott, MT(ASCP)

Making a Sharp Example Lisa J .Prescott, MT(ASCP). 22nd Maine Geriatrics Conference 2012 Bar Harbor, Me . Overview. Community medical sharps What devices are considered medical sharps Who uses these medical devices The problem Special concerns with older individuals

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Making a Sharp Example Lisa J .Prescott, MT(ASCP)

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  1. Making a Sharp ExampleLisa J .Prescott, MT(ASCP) 22nd Maine Geriatrics Conference 2012 Bar Harbor, Me

  2. Overview Community medical sharps • What devices are considered medical sharps • Who uses these medical devices • The problem • Special concerns with older individuals • What can be done in Maine • The Aroostook County Solution • Questions

  3. What are medical “Sharps”? • Sharps include items that are capable of puncturing the skin such as syringes, needles, lancets, or similar sharp objects.

  4. Who Uses Medical Sharps? • Diabetics are the largest group using lancets, needles, and syringes • About 1/3 of use is illicit drug use • 2/3 of use is medical

  5. It is estimated that 1 in every 12 households uses some type of medical sharp • In Maine alone, individuals complete 12 million injections by sharps every year. • In Aroostook County, more than 6,000 people use sharps on a routine basis.

  6. Who Uses Medical Sharps? • Other medical use in the home : • Arthritis • Osteoporosis • multiple sclerosis • HIV/AIDS • hepatitis C • migraines • Cancer

  7. Who Uses Medical Sharps? • Psoriasis • Infertility • Allergies • Anemia • self administration of blood thinners • growth hormone injections • Pet/livestock owners

  8. What are the Statistics? “13.5 million people in the United States are discarding 7.8 billion used needles outside the traditional healthcare setting. ” (This number doesn’t reflect veterinary useage) October 13, 2011- Jenny Schumann, Coalition for Safe Community Needle Disposal

  9. What is the Problem? • 4 percent of users put used needles in a puncture-resistant container • 3 percent flush them down the toilet • 93 percent throw them in the trash. Tom Erickson, CEO of Ulti-Med, Inc. (McConville & Hamilton, 2002).

  10. If they do get put into a container, containers are thrown into the regular waste stream and often break open or apart on their way to their final destination in a landfill.

  11. Going back to the user statistics “a tripling of the number of used needles tossed into household garbage during last 10 years” Coalition for Safe Community Needle Disposal

  12. Because of Improper Disposal Sharps in the environment (waterways, beaches, etc) Needle stick Injuries with used sharps in homes, in public areas… places where one wouldn’t suspect such hazards to exist. Each year some 600,000 to 800,000 sharps related injuries occur in the U.S.

  13. The Problem (cont) • Many needle sticks go unnoticed in the public or are unreported • Children are especially vulnerable • Everyone is at risk of a needle stick injury because of the extent of the problem. People at higher risk are those whose occupation puts them in more frequent contact with used sharps such as waste haulers .

  14. What are the Real Dangers of a needle stick injury? Blood Bourne infections: HIV /AIDS) HBV- Hepatitis B Virus HCV- Hepatitis C Virus Tetanus

  15. The Risk • Hepatitis B – no risk if person has been immunized; 6-30% risk if not • Hepatitis C – no vaccine; 1.8% • HIV- 0.3% or 1 in 300 chance if exposed-no vaccine – some anti-retroviral drugs may reduce transmission but these drugs have serious side effects.

  16. Infection With HCV The most common blood borne illness, the leading cause of chronic liver disease, and the primary reason for liver transplant in the U.S. • Acute Hepatitis • Chronic Disease – Cirrhosis- Many of the 3.2million people living with this infection are unaware. • Liver Cancer • Death

  17. Scary to get a needle stick • Health care workers are used to the risk- use universal precautions • People in the public are unaware of risks and unfamiliar with the followup. This causes a lot of anxiety.

  18. Followup : • Vaccines for tetanus/hep B • Blood work to check for immunity; exposure to HCV, HIV, Hep B, and liver enzymes • Blood work again (1-2 mo for Hep B vaccine) • And 4-6 months more blood work to check for signs of HCV infection; liver enzymes again.

  19. We live in Maine….and we’re dealing with an older population Life is good and we know the statistics but we really don’t deal with this stuff… Or do we?

  20. Maine Statistics Hepatitis B, acute Case Total 13 Maine Rate 1.0 per 100,000 U.S.rate (2009) 1.1 per 100,000 Maine Center for Disease Control and Prevention 2010

  21. The incidence of acute hepatitis B is nearly 2x as high among adults with diabetes as in those without • Reported by Internal Medicine News 3/3/11

  22. Maine Statistics Hepatitis B, chronic 2010 Case Total 101 Maine Rate 7.7 per 100,000 U.S.rate (2009) Not available Maine Center for Disease Control and Prevention 2010

  23. Maine Statistics Hepatitis C 2010 Case Total 1142 Maine Rate 87.0 per 100,000 U.S. rate (2009) N/A Maine Center for Disease Control and Prevention 2010

  24. Chronic Hepatitis C Virus Infection in Older Adults • Most acquired the disease earlier in life • “The burden of chronic HCV infection in elderly persons is expected to increase significantly in the US during the next two decades” • “Chronic infection may be more severe in the elderly” Journal of Clinical Infectious Disease(2005)

  25. Older Individuals… • Are often overwhelmed by their medical diagnosis and problems • Easily confused/forgetful • May be in group settings where blood borne infection can occur through shared contaminated devices • May not realize the risk of their used contaminated sharps • May not know that they have a infection

  26. How it all Started: My Story • Elderly Diabetic Inpatient –evaluated for MI • A “pet mission” • What I discovered

  27. How it all started… 1. One individual-2010 2. The Cary Medical Center Laboratory 2. A Vision to protect the Community 3. Cary Medical Center Administration support 4. Cary Medical Center Committee 5. Community Support

  28. “Education is the most powerful weapon which you can use to change the world.” ― Nelson Mandela

  29. A Safer Aroostook Community Leaders

  30. Our Mission We are a Cary Medical Center Committee formed to investigate and implement community safe needle disposal in Aroostook County as well as develop educational programs for the public about safe needle disposal.

  31. Education • Brochures- full color tri-fold brochure. • Public Service TV and Radio Spots • Web site Promotions • Press Releases • Public Presentations • Exhibits at health fairs and trade shows

  32. Advocacy: • Cary Medical Center Committee will monitor efforts and advocate for the Community Sharps legislation and associated rulings in the State. Aroostook County Pilot is a model for legislative and community efforts to establish workable solutions in sharps collection and safety.

  33. Home Containers • Free personal sharps containers. Customized with names of sponsors. • Available currently at diabetes education classes, Pines offices, Police Depts, and Cary Medical Center Laboratory

  34. Needle Collection Kiosk

  35. Features and Cost • $2900 to purchase • Electronic sensors/light- signal when container is ½ full; battery operated • Tamper proof features- similar to “book-drop” at library; heavy gauge sheet metal • Lock when full • Customizable with sponsor’s names and insignia

  36. Kiosk’s Location Initial Sites • Caribou Police Department • Presque Isle Police Department-(added later ) 7days/wk;24 hours/day

  37. Our Kiosk Partners Police Departments chosen because of: • Accessibility • Willingness & Training • Added/Fit with unused prescription drug collection efforts • Currently had sharps dropped off • Commitment to pick up and drop off personal sharps containers to the elderly and shut-ins.

  38. February 23, 2011 Press Release: “On Wednesday, February 23, 2011, Cary Medical Center, with the generous support of the Caribou Rotary Club, launched the Cary Medical Center Safe Sharps Disposal program.”

  39. The pilot program • free personal sharps containers, • brochures to the public • community drop off /sharps disposal kiosk located at the Caribou Police Department • Oxus Environmental, a waste disposal facility located in Pittsfield, Me., picked up sharps collected in the kiosk.

  40. Adaptations A decision to move the waste disposal site occurred in June 2011, after discussion with the committee and key partners. Costs of the program dictated this move in order to ensure sustainability. Nick Archer, Regional Director of the Northern Maine Regional Office, Maine Department of Environmental Protection (DEP) worked with the Maine State DEP allowing the Cary program to dispose of the waste in the local landfills.

  41. Both Presque Isle and Tri Community Landfills agreed to take the sharps free of charge and dispose of them in a safe manner. Agreement to provide all the protections previously provided in the Oxus disposal agreement, and maintain public safety were reached.

  42. Sharps from the Police Departments would go directly by Cary transportation or landfill transportation to designated landfills and be disposed of immediately in an area away from public access.

  43. Expanding the program The Cary Community Sharps Disposal Program added a kiosk and drop off location at the Presque Isle Police Department on November 15th, 2011 as a result of the generous support from the Maine Community Foundation.

  44. February 2012 First Public Service Announcement is produced at WAGM by Cary Medical Center and the Northern Maine Development Commission with funding provided by a solid waste management grant through the United States Department of Agriculture (USDA).

  45. Businesses/organizations that provided financial support • American Legion Auxiliary • Caribou Police Department • Caribou Rotary • Cary Medical Center • City of Presque Isle • Maine Community Foundation • Northern Maine Development Commission • Pines Health Services • Presque Isle Kiwanis • Presque Isle Police Department • Tri-Community Landfill • United Baptist Church

  46. Other contributors with expertise, letters of commitment, etc. • Aroostook Area Agency on Aging • Caribou Fire andProtection Agency • Oxus Environmental • University of Maine at Presque Isle  • Ambulance • Chrysalis Environmental Solutions • City of Caribou • Healthy Aroostook • Jefferson Cary Foundation • Maine Department of Environmental Protection • Maine Environmental • Coalition for Safe Needle Disposal

  47. Our Cary Medical Center Safe Sharps Disposal Program can’t put a number to how many sharps injuries we have prevented in our local communities.

  48. As of April 30,2012: over 4150 lbs of used medical sharps have been collected at two sites over 1500 personal sharps containers Approximately 500 brochures have been distributed.

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