Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-28T02:36:05.663Z Has data issue: false hasContentIssue false

Effect of Implementing Safety-Engineered Devices on Percutaneous Injury Epidemiology

Published online by Cambridge University Press:  02 January 2015

SeJean Sohn
Affiliation:
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
Janet Eagan
Affiliation:
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
Kent A. Sepkowitz*
Affiliation:
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
Gianna Zuccotti
Affiliation:
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
*
Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021

Abstract

Objective:

To assess the effect of implementing safety-engineered devices on percutaneous injury epidemiology, specifically on percutaneous injuries associated with a higher risk of blood-borne pathogen exposure.

Design:

Before-and-after intervention trial comparing 3-year preintervention (1998–2000) and 1-year postintervention (2001–2002) periods. Percutaneous injury data have been entered prospectively into CDC NaSH software since 1998.

Setting:

A 427-bed, tertiary-care hospital in Manhattan.

Participants:

All employees who reported percutaneous injuries during the study period.

Intervention:

A “safer-needle system,” composed of a variety of safety-engineered devices to allow for needle-safe IV delivery, blood collection, IV insertion, and intramuscular and subcutaneous injection, was implemented in February 2001.

Results:

The mean annual incidence of percutaneous injuries decreased from 34.08 per 1,000 full-time–equivalent employees preintervention to 14.25 postintervention (P < .001). Reductions in the average monthly number of percutaneous injuries resulting from both low-risk (P < .01) and high-risk (P was not significant) activities were observed. Nurses experienced the greatest decrease (74.5%, P < .001), followed by ancillary staff (61.5%, P = .03). Significant rate reductions were observed for the following activities: manipulating patients or sharps (83.5%, P < .001), collisions or contact with sharps (73.0%, P = .01), disposal-related injuries (21.41%, P = .001), and catheter insertions (88.2%, P < .001). Injury rates involving hollow-bore needles also decreased (70.6%, P < .001).

Conclusions:

The implementation of safety-engineered devices reduced percutaneous injury rates across occupations, activities, times of injury, and devices. Moreover, intervention impact was observed when stratified by risk for blood-borne pathogen transmission.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.National Institute for Occupational Safety and Health. NIOSH Alert: Preventing Needlestick Injuries in Health Care Settings. Washington, DC: National Institute for Occupational Safety and Health; 1999. DHHS (NIOSH) publication no. 2000-108.Google Scholar
2.Panlilio, AL, Cardo, DM, Campbell, S, et al.Estimate of the annual number of percutaneous injuries in US health care workers. Presented at 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections; March 5-9, 2000; Atlanta, GA. Abstract ID S-T2-01.Google Scholar
3.Perry, J. CDC releases national needlestick estimates. Advances in Exposure Prevention 2000;5:19.Google Scholar
4. Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens, final rule. 29 CFR 1910.1030 (1991).Google Scholar
5. Needlestick Safety and Prevention Act of 2000. Pub L No. 106-430, 114 Stat 1901 (2000).Google Scholar
6.Laufer, FN, Chiarello, LA. Application of cost-effectiveness methodology to the consideration of needlestick-prevention technology. Am J Infect Control 1994;22:7582.Google Scholar
7.Roudot-Thoraval, F, Montagne, O, Schaeffer, A, Dubreuil-Lemaire, M, Hachard, D, Durand-Zaleski, I. Costs and benefits of measures to prevent needlestick injuries in a university hospital. Infect Control Hosp Epidemiol 1999;20:614617.CrossRefGoogle ScholarPubMed
8.Gartner, K. Impact of a needleless intravenous system in a university hospital. Am J Infect Control 1992;20:7579.Google Scholar
9.Gershon, RR, Pearse, L, Grimes, M, Flanagan, PA, Vlahov, D. Impact of multifocused interventions on sharps injury rates at an acute-care hospital. Infect Control Hosp Epidemiol 1999;20:806811.Google Scholar
10.Tan, L, Hawk, JC, Sterling, ML. Report of the Council on Scientific Affairs: preventing needlestick injuries in health care settings. Arch Intern Med 2001;161:929936.Google Scholar
11.Nguyen, M, Paton, S, Villeneuve, PJ. Update. Surveillance of healthcare workers exposed to blood/body fluids and bloodborne pathogens: 1 April, 2000 to 31 March, 2001. Can Commun Dis Rep 2001;27:201209.Google Scholar
12.Orenstein, R, Reynolds, L, Karabaic, M, Lamb, A, Markowitz, SM, Wong, ES. Do protective devices prevent needlestick injuries among health care workers? Am J Infect Control 1995;23:344351.CrossRefGoogle ScholarPubMed
13.Jagger, J, Bentley, MB, Collaborative EPINet Surveillance Group. Injuries from vascular access devices: high risk and preventable. Journal of Intravenous Nursing 1997;20(suppl):S33S39.Google ScholarPubMed
14.Jagger, J, Hunt, EH, Pearson, RD. Sharp object injuries in the hospital: causes and strategies for prevention. Am J Infect Control 1990;18:227231.Google Scholar
15.Yassi, A, McGill, ML, Khokhar, JB. Efficacy and cost-effectiveness of a needleless intravenous access system. Am J Infect Control 1995;23:5764.Google Scholar
16.Centers for Disease Control and Prevention. Surveillance: National Surveillance System for Health Care Workers. Atlanta, GA: Centers for Disease Control and Prevention; 2000. Available at www.cdc.gov/ncidod/hip/SURVEILL/nash.htm. Accessed June 22, 2004.Google Scholar
17.U.S. Department of Health and Human Services. Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures: Minneapolis-St. Paul, New York City and San Francisco, 1993-1995. MMWR 1997;46:2124.Google Scholar
18.Centers for Disease Control and Prevention Cooperative Needlestick Surveillance Group. Case-control study of HIV seroconversion in health-care workers after percutaneous exposure to HIV-infected blood: France, United Kingdom, and United States, January 1988-August 1994. MMWR 1995;44:929933.Google Scholar
19.Sepkowitz, KA. Occupationally acquired infections in health care workers, part 2. Ann Intern Med 1996;125:917928.CrossRefGoogle Scholar
20.Alvarado, F, Panlilio, A, Cardo, D, NaSH Surveillance Group. Percutaneous injury reporting in US hospitals, 1998. Presented at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections; March 5-9, 2000; Atlanta, GA. Abstract ID P-S2-38.Google Scholar
21.International Health Care Worker Safety Center. Exposure Prevention Information Network (EPINet) Data Reports. Charlottesville, VA: University of Virginia; 1999.Google Scholar
22.Han, LC, Schoen, HM, Eagan, JA, Harold, MJ, Sohn, S, Sepkowitz, KA. Appropriate usage of safer needles at a cancer hospital. Presented at the 29th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control and Epidemiology; May 19-23, 2002; Nashville, TN.Google Scholar
23.Pugliese, G, Germanson, TP, Bartley, J, et al.Evaluating sharps safety devices: meeting OSHA's intent. Infect Control Hosp Epidemiol 2001;22:456458.CrossRefGoogle ScholarPubMed
24.Sohn, S, Eagan, JA, Sepkowitz, KA. Impact of a safer-needle system on percutaneous injury reporting behavior. Presented at the 13th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; April 5-8, 2003; Arlington, VA. Abstract 122.Google Scholar