Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program

1. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program

2. The Problem of Sharps Injuries • CDC estimates ~385,000 sharps injuries annually among hospital-based healthcare personnel* • Sharps injuries are a hazard • Increased risk for bloodborne virus transmission • Cost to workers and healthcare system *Panlilio AL, et al. Infect Control Hosp Epidemiol, 2004

3. Sharps Injuries Are Preventable Preventability of Needlestick Injuries involving Hollow-bore Needles in 78 NaSH Hospitals, June 1995 to December 2004 (n=11,625)

4. Bloodborne Virus Transmission Virus Hepatitis B virus (HBV) Hepatitis C virus (HCV) Human immunodeficiency virus (HIV) Risk from Percutaneous Injury 6%-30%* Approx. 2% 0.3% *Risk applies to unvaccinated workers only

5. The Costs of Sharps Injuries • Medical costs • $71 to ~$5,000 per exposure* • Lost time from work • Emotional cost • Long-term costs * O’Malley EM, et al. Infect Control Hosp Epidemiol, 2007

6. Needlestick Safety and Prevention Act (2000) • Federal OSHA standard requires: • Use of engineering and work practice controls • Recordkeeping on a Sharps Injury Log • Written Exposure Control Plan

7. Exposure Control Plan • Must reflect changes in technology use for prevention • Document annual consideration, evaluation of safer sharps devices • Employers are required to solicit input from direct patient care personnel regarding the identification and selection of engineering and work practice controls.

8. Recent OSHA Citations • July 2003: Fined nursing home $92,500 for “serious” and “willful” violations • Levied maximum fine for willful violations: failure to utilize sharps safety devices • September 2003: Hospital fined $9,000 • Complaint filed by staff that safety-engineered devices were not available Source: Advances in Exposure Prevention

10. Purpose of Workbook • Assist healthcare facilities to organize a sharps injury prevention program • All-in-one tool that helps: • Develop and maintain aprogram • Enhance or augmentexisting programs

11. The Workbook will help… • Assessa facility’s sharps injury prevention program • Document a prevention plan and implementation of activities • Evaluate the impact of prevention measures

12. Contents of the Workbook • Overview of sharps injury epidemiology and prevention strategies • Organization-wide method of developing prevention program • Based on model of Continuous Quality Improvement (CQI) • Program model of operational processes • Program resources

13. Organizational Steps • Develop organizational capacity • Form a multidisciplinary leadership team • Assess the operational processes of the prevention program • Prepare a baseline profile of sharps injuries and current prevention activities

14. Organizational Steps (cont’d.) • Determine prevention priorities • Develop and implement Action Plan • Action plan focuses on reducing injuries and improving program activities • Monitor performance improvement

15. Operational Processes Essential activities of any sharps injury prevention program

16. Operational Processes • The 5 processes: • Develop an institution-wide culture of safetyin the work environment • Promote reporting of sharps injuries and injury hazards • Analyze sharps injury data for prevention planning • Select/evaluate sharps injury prevention devices • Educate and train healthcare personnel

17. Operational Processes: Culture of safety: the shared commitment of management and employees to ensure the safety of patients and personnel • Measures of safety culture are linked to: • Reductions in sharps injuries • Personnel compliance with safe work practices • Availability of devices with engineered safety features • Workbook contains: • Strategies for creating a culture of safety • Survey form for measuring the safety “climate” among personnel Culture of Safety

18. Operational Processes: • Under-reporting of sharps injuries continues to be an issue at healthcare facilities • Varies by occupation, department and facility • Is influenced by the safety culture and safety climate • CDC NaSH data from 38 hospitals, 1996-2003 • only 45% of total injuries are reported Injury Reporting

19. Operational Processes: • Workbook tools: • Reporting survey • Blood and body fluid exposure report form • Sharps injury hazard observation and report forms • Root cause analysis form Injury Reporting (cont’d.)

20. Operational Processes: • Analysis of sharps injury data drives prevention planning • Workbook features: • Instructions for compiling and analyzing data • Directions for calculating sharps injury rates Analysis of Data

21. Operational Processes: • A Systematic approach for selecting devices ensures: • comprehensive review of devices • thorough selection process • Key elements of this approach: • Team input • Review current device use, prioritize devices for consideration • In-use evaluation of new devices Selection/Evaluation of Devices

22. Operational Processes: • Workbook tools: • Survey of device use (by department or unit) • Device pre-selection worksheet • Device evaluation form Selection/Evaluation of Devices (cont’d.)

23. Operational Processes: • Workbook features: • General guidance on sharps injury prevention education and training • List of websites of other educational resources Education and Training of Personnel

24. Other Resources • Sections on safe work practices and problem-specific strategies for preventing sharps injuries • Cost analysis • Sample form for estimating cost of needlesticks • Sample form for estimating device-specific injury costs • Sample form for estimating device implementation costs

26. Summary • Sharps injuries are an important concern • Increased risk of disease transmission • High costs to personnel and healthcare system • Most sharps injuries are preventable • Needlestick Safety and Prevention Act requires prevention efforts be undertaken

27. Summary (cont’d.) • Workbook is a comprehensive collection of valuable resources • Valuable in development of sharps injury prevention program • Potential to enhance current prevention activities

28. Summary (cont’d.) • Useful Workbook tools may benefit other organizational processes by: • Enhancing teamwork • Improving perceptions of safety culture • Reducing costs due to more effective, focused prevention efforts

30. Optional Extra Slides

39. Sharps Injuries at [insert your hospital name] by Distribution of Safety Device

40. Sharps Injuries at [insert your hospital name] by Device

41. Sharps Injuries at [insert your hospital name] by Work Location

42. Sharps Injuries at [insert your hospital name] by Occupational Group