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Implementation of an Enhanced Safety-Engineered Sharp Device Oversight and Bloodborne Pathogen Protection Program at a Large Academic Medical Center

  • Thomas R. Talbot (a1), Deede Wang (a2), Melanie Swift (a3) (a4), Paul St. Jacques (a5), Susan Johnson (a6), Vicki Brinsko (a2), Valerie Thayer (a4), Teresa Dail (a7), Nancye Feistritzer (a7) and Shea Polancich (a8)...

Abstract

Objective.

Exposure of healthcare personnel to bloodborne pathogens (BBPs) can be prevented in part by using safety-engineered sharp devices (SESDs) and other safe practices, such as double gloving. In some instances, however, safer devices and practices cannot be utilized because of procedural factors or the lack of a manufactured safety device for the specific clinical use. In these situations, a standardized system to examine requests for waiver from expected practices is necessary

Design.

Before-after program analysis.

Setting.

Large academic medical center.

Interventions.

Vanderbilt University Medical Center developed a formalized system for an improved waiver process, including an online submission and tracking site, and standards surrounding implementation of core safe practices. The program’s impact on sharp device injuries and utilization of double gloving and blunt sutures was examined.

Results.

Following implementation of the enhanced program, there was an increase in the amount of undergloves and blunt sutures purchased for surgical procedures, suggesting larger utilization of these practices. The rate of sharp device injuries of all at-risk employees decreased from 2.32% to 2.12%, but this decline was not statistically significant (P = .14). The proportion of reported injuries that were deemed preventable significantly decreased from 72.7% (386/531) before implementation to 63.9% (334/523; P = .002) after implementation of the enhanced program.

Conclusions.

An enhanced BBP protection program was successful at providing guidance to increase safe practices and at improving the management of SESD waiver requests and was associated with a reduction in preventable sharp device injuries.

Copyright

Corresponding author

A2200 Medical Center North, 1161 21st Avenute South, Nashville, TN 37232 (tom.talbot@vanderbilt.edu).

References

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1. Occupational Safety and Health Administration (OSHA). Standard on Bloodborne Pathogens (1930.1030), 1993, revised 2003. Washington, DC: OSHA, 2003. http://www.osha.gov/SLTC/bloodbornepathogens/standards.html. Accessed February 18, 2014.
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4. Wilson, SJ, Sellu, D, Uy, A, Jaffer, MA. Subjective effects of double gloves on surgical performance. Ann R Coll Surg Engl 1996;78(1):2022.
5. St Germaine, RL, Hanson, J, de Gara, CJ. Double gloving and practice attitudes among surgeons. Am J Surg 2003;185(2):141145.
6. Fry, DE, Harris, WE, Kohnke, EN, Twomey, CL. Influence of double-gloving on manual dexterity and tactile sensation of surgeons. J Am Coll Surg 2010;210(3):325330.
7. Vanderbilt University Medical Center. Vanderbilt University Medical Center Factbook 2012–13. Nashville, Tennessee: Vanderbilt University Medical Center, 2013. http://www.mc.vanderbilt.edu/documents/main/files/vumc_facts_2012-21013.pdf. Accessed February 18, 2014.
8. Jagger, J, Perry, J. Safety-engineered devices in 2012: the critical role of healthcare workers in device selection. Infect Control Hosp Epidemiol 2013;34(6):615618.
9. Black, L. Chinks in the armor: percutaneous injuries from hollow bore safety-engineered sharps devices. Am J Infect Control 2013;41(5):427432.

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