CHINKS IN THE ARMOR: PERCUTANEOUS INJURIES FROM SAFETY ENGINEERED SHARPS DEVICES

2.50
Hdl Handle:
http://hdl.handle.net/10755/211458
Type:
Research Study
Title:
CHINKS IN THE ARMOR: PERCUTANEOUS INJURIES FROM SAFETY ENGINEERED SHARPS DEVICES
Abstract:
PURPOSES/AIMS: To evaluate epidemiologic factors contributing to percutaneous injuries (PIs) from hollow-bore safety-engineered sharp devices (SESDs) since the November 6, 2000 passage of the Needlestick Safety and Prevention Act (NSPA). RATIONALE/CONCEPTUAL BASIS/BACKGROUND: The most recent published data estimate that US hospital-based healthcare workers (HCWs) sustain approximately 384,325 PIs annually. These exposures have resulted in transmission of diseases such as HIV, HBV, and HCV to HCWs. Following implementation of the NSPA, U.S. healthcare employers were mandated to implement needle devices.  The success and cost-effectiveness of safety engineered sharps devices (SESDs) in preventing PIs in HCWs has subsequently been documented in numerous empirical studies comparing conventional needles to their safety counterparts. SESD designs generally fall into two categories: active devices that require action on the part of the healthcare worker and passive devices that are automatically activated after use. Previous authors have shown that passive devices requiring no action on the part of the user are the most effective in preventing injury, are the most similar to conventional devices with regard to user technique, and are the most readily accepted by healthcare staff.  Though broad implementation of SESDs in healthcare settings has dramatically decreased PI rates in hospitals, safety devices that have a needle attached do still cause a residual fraction of sharps injuries. Injuries from SESDs may occur during use of the item, during activation of the safety mechanism, or from failure to activate an available safety feature. METHODS: Retrospective review was conducted of secondary injury data from 3,297 hollow-bore percutaneous injuries (HBPIs) from SESDs in 62 hospitals occurring between 2001 and 2009. Injury reports were obtained from Exposure Prevention Information Network (EPINet) needlestick surveillance database, maintained by the International HealthCare Worker Safety Center. Descriptive data measuring SESD-related injury epidemiology and analytic comparison statistics were calculated. RESULTS: 64% of reported SESD injuries were sustained by nurses; a greater number than for all other HCW categories combined. The majority (57.5%; N = 1,869) of SESD injuries were superficial in nature and most (84.7%; N = 2,775) were sustained by the original user of the device. SESD failure was rare, and accounted for a negligible proportion of reported injuries. An available safety feature was either fully or partially activated in only 13.2% of physician injuries, 29.2% of nursing injuries, and 33.7% of phlebotomy injuries from SESDs. Excluding injuries occurring during device use (when SESD activation is not possible), 23% of physician injuries, 29.5% of nursing injuries, and 21% of phlebotomy injuries were potentially preventable had an available safety feature been engaged. IMPLICATIONS: Across the HCW categories, 21% - 29.5% of SESD injuries reported in this study could have been prevented through SESD activation. Despite their proven efficacy, passive devices that do not require action on the part of the end user currently represent a small portion of the SESD market. Wider dissemination of a broader array of passive SESDs coupled with continual education of end users is essential to an effective sharps injury prevention program.
Keywords:
Percutaneous injuries; Hollow-bore safety-engineered sharp devices
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5151
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleCHINKS IN THE ARMOR: PERCUTANEOUS INJURIES FROM SAFETY ENGINEERED SHARPS DEVICESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211458-
dc.description.abstractPURPOSES/AIMS: To evaluate epidemiologic factors contributing to percutaneous injuries (PIs) from hollow-bore safety-engineered sharp devices (SESDs) since the November 6, 2000 passage of the Needlestick Safety and Prevention Act (NSPA). RATIONALE/CONCEPTUAL BASIS/BACKGROUND: The most recent published data estimate that US hospital-based healthcare workers (HCWs) sustain approximately 384,325 PIs annually. These exposures have resulted in transmission of diseases such as HIV, HBV, and HCV to HCWs. Following implementation of the NSPA, U.S. healthcare employers were mandated to implement needle devices.  The success and cost-effectiveness of safety engineered sharps devices (SESDs) in preventing PIs in HCWs has subsequently been documented in numerous empirical studies comparing conventional needles to their safety counterparts. SESD designs generally fall into two categories: active devices that require action on the part of the healthcare worker and passive devices that are automatically activated after use. Previous authors have shown that passive devices requiring no action on the part of the user are the most effective in preventing injury, are the most similar to conventional devices with regard to user technique, and are the most readily accepted by healthcare staff.  Though broad implementation of SESDs in healthcare settings has dramatically decreased PI rates in hospitals, safety devices that have a needle attached do still cause a residual fraction of sharps injuries. Injuries from SESDs may occur during use of the item, during activation of the safety mechanism, or from failure to activate an available safety feature. METHODS: Retrospective review was conducted of secondary injury data from 3,297 hollow-bore percutaneous injuries (HBPIs) from SESDs in 62 hospitals occurring between 2001 and 2009. Injury reports were obtained from Exposure Prevention Information Network (EPINet) needlestick surveillance database, maintained by the International HealthCare Worker Safety Center. Descriptive data measuring SESD-related injury epidemiology and analytic comparison statistics were calculated. RESULTS: 64% of reported SESD injuries were sustained by nurses; a greater number than for all other HCW categories combined. The majority (57.5%; N = 1,869) of SESD injuries were superficial in nature and most (84.7%; N = 2,775) were sustained by the original user of the device. SESD failure was rare, and accounted for a negligible proportion of reported injuries. An available safety feature was either fully or partially activated in only 13.2% of physician injuries, 29.2% of nursing injuries, and 33.7% of phlebotomy injuries from SESDs. Excluding injuries occurring during device use (when SESD activation is not possible), 23% of physician injuries, 29.5% of nursing injuries, and 21% of phlebotomy injuries were potentially preventable had an available safety feature been engaged. IMPLICATIONS: Across the HCW categories, 21% - 29.5% of SESD injuries reported in this study could have been prevented through SESD activation. Despite their proven efficacy, passive devices that do not require action on the part of the end user currently represent a small portion of the SESD market. Wider dissemination of a broader array of passive SESDs coupled with continual education of end users is essential to an effective sharps injury prevention program.en_GB
dc.subjectPercutaneous injuriesen_GB
dc.subjectHollow-bore safety-engineered sharp devicesen_GB
dc.date.available2012-02-20T11:56:18Z-
dc.date.issued2012-02-20T11:56:18Z-
dc.date.accessioned2012-02-20T11:56:18Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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