Michelle enjoyed working in the pediatric wing of the hospital and had been there almost seven years. An infant was admitted to the hospital with some serious symptoms. His mother was HIV positive and not on any medication. All the staff were very careful when starting the baby's I.V. and drawing blood for the admission tests. Everything was going very smoothly. That is, until Michelle began to clean up the garbage, wrappers, empty syringes, and gauze and suddenly started screaming that she had gotten stuck. It was only moments before she realized that she had been stuck with a contaminated needle because another nurse failed to put it in the sharps container. Michelle almost passed out and had to sit down for a few minutes before she could function again. Her life would never be the same.
Real stories such as Michelle's happen in institutions across the United States, even though almost four years have passed since OSHA mandated sharps safety. Yet, many institutions are not in compliance.
Another real-life story can help illustrate the problem further.
In order to maintain my good health, I scheduled a procedure at an endos-copy clinic.
After filling out the appropriate paperwork, I was escorted into the prep area where my vital signs were taken and an I.V. was started in my hand.
After talking with the doctor and nurse in the procedure room, I was administered Versed, which is a sedative that ensures a patient won't remember any discomfort or pain experienced during a procedure.
I asked the nurse why she was injecting a needle into an injection cap instead of using a needlefree adapter.
I also told her that she was breaking OSHA guidelines as she recapped the needle and that her institution could be fined if OSHA knew that her clinic was not in compliance.
Rather than answer my question, she took the cap off of the needle and injected more medication so I would shut up and not remember anything.
Health care workers, however, should not turn away from their intuition that tells them when they are not in compliance.
OSHA guidelines have been put in place to protect workers--not to irritate them.
As a child, I remember sitting on my father's lap helping him steer the car as he drove down the street. I thought it was great fun.
With the clarity of 20/20 hindsight, I recognize that practice was placing both of us at great risk.
Now, I would not dream of placing any of my sweet children or grandchildren in such a risky position.
Since that time, laws have been passed that mandate seat belts and child safety restraints. These laws were not put in place to irritate the driving public, they were implemented to decrease the number of deaths and injuries occurring each year.
OSHA guidelines serve the same purpose. They are in place to prevent occupational exposure and infection from bloodborne pathogens.
One of my daughters recently became a certified nursing assistant while in high school and plans on pursuing a career in health care.
I told her that there are a few guidelines that I would suggest she follow in order to protect her good health now and for years to come. Let me share them with you.
- Never recap a needle using your hands. It is foolhardy to place your hand in front of a contaminated needle. According to the Bloodborne Pathogen Standard, contaminated needles cannot be recapped unless the employer can demonstrate that no alternative is feasible. If recapping is necessary, it must be accomplished through the use of a mechanical device or a one-handed scooping technique.
- Always dispose of used needles and syringes directly into a sharps bin for disposal. Never detach the needle prior to disposal because this is when many needlesticks occur.
- Make sure that a sharps bin is available at the point of use to enable immediate disposal. Always take the responsibility of disposing of all sharps that you use--don't leave them for someone else to clean up.
- When sharps containers are filled to their fill line, promptly replace them so that you will not run the risk of getting stuck with needles pushing out through the top of an overfilled sharps container.
- Volunteer to participate in your facility's sharps safety committee. Become involved in learning and updating the Exposure Control Plan. Part of the OSHA requirements is that the exposure control plan is updated at least annually. This update must include an evaluation of new safety technologies.
- Encourage your committee to have frequent safety fairs where the safety products of many medical device companies can be examined. Encourage them to evaluate many safety products so that the whole spectrum of safety products can be presented. Many institutions know about safety syringes and safety scalpels. There are additional categories where safety products should be considered such as lancets for capillary blood testing, wound irrigation products that do not present the risk of needlesticks, safety umbilical cord clampers and cutters, etc.
- Become trained on all new safety products. Make sure that you attend all in-service meetings where training is offered. If unable to attend, contact the vendor directly to arrange training. Many needlestick injuries still happen to those who are not trained on a safety product and have not activated the safety feature.
- Use plastic products as an alternative to glass whenever possible. This is particularly important for those who work in hospital laboratories.
- Always wear the appropriate personal protective equipment
that any
procedures call for. Splashes and contamination in eyes and on skin and mucous membranes can transmit bloodborne pathogens. This in-cludes eye and face protection when necessary.
Accidents are going to happen. However, health care workers can be proactive by minimizing accidents, purposefully planning for the worst and seeking out safety products for themselves and their institutions. We should all be proactive in promoting our own health and safety. We should not be guilty of silencing the voice of safety in our health care facilities.
Ron Stoker is the founder and executive director of the International Sharps Injury Prevention Society. He has been involved in the medical device industry for more than 25 years. Stoker is in the final stages of writing a book detailing every sharps injury prevention and blood exposure prevention product commercially available. To reserve a copy of the book or to contact Stoker, send an e-mail to ron@isips.org.
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