How Healthcare Leaders Can Improve Sharps Safety

Jane Perry and Elayne Kornblatt Phillips for HealthLeaders Media , December 6, 2011

Improving compliance in the OR
In the surgical setting, four strategies recommended by the American College of Surgeons and other experts should guide efforts to reduce sharps injuries:

  1. Implementation of blunt-tip suture needles
  2. Use of other safety devices such as shielded scalpels
  3. Use of the hands-free passing technique
  4. Double gloving5-6

The number one cause of injury in the OR is suture needles, but not enough surgeons are using the safer alternative.7 "Blunt" suture needles can be used to suture internal tissue such as muscle and fascia, but they are not sharp enough to penetrate skin.

Over the last decade, manufacturers have improved the design of these needles, and offer a wider range of suture/needle combinations; blunt suture needles also have the advantage of being cost neutral (roughly the same cost as conventional ones).

About a third of scalpel-related injuries occur during passing, and many of those injuries are sustained by the person on the receiving end of the transfer.7 Establishing a mandatory hands-free or "neutral" zone is a key work practice to help reduce injury risk.8 A neutral zone can be created in a variety of ways.

At least three options have been identified that are suitable for most surgical procedures—a commercial product marketed specifically for this purpose, an emesis or square basin, or a magnetic pad.9 The scrub person should inform the surgical team which method will be used during the time-out prior to surgery.

Keeping your institution's sharps safety program up-to-date and effective will always be a work in progress. In 2001, the Centers for Disease Control and Prevention (CDC) included the elimination of needlestick injuries on a list of seven "Healthcare Safety Challenges." While that goal is lofty—and perhaps unreachable as long as we use sharp devices in caring for patients—every healthcare facility can strive to reduce sharps injuries and blood exposures to, as OSHA says, the "lowest feasible extent."

Continued vigilance is necessary to ensure that effective and appropriate sharps safety technology and work practices are available and consistently used in hospitals and outpatient settings nationwide.

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