Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T04:27:19.368Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  10 May 2016

Thomas R. Talbot ,
Deede Wang ,
Melanie Swift ,
Paul St. Jacques ,
Susan Johnson ,
Vicki Brinsko ,
Valerie Thayer ,
Teresa Dail ,
Nancye Feistritzer  and
Shea Polancich
Thomas R. Talbot*
Affiliation:
Department of Medicine, Division of Infectious Diseases, and Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee
Deede Wang
Affiliation:
Department of Quality, Safety, and Risk Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Melanie Swift
Affiliation:
Department of Medicine, Division of General Internal Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Paul St. Jacques
Affiliation:
Department of Anesthesiology and Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee
Susan Johnson
Affiliation:
Environmental Health and Safety, Vanderbilt University Medical Center, Nashville, Tennessee
Vicki Brinsko
Affiliation:
Department of Quality, Safety, and Risk Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Valerie Thayer
Affiliation:
Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Teresa Dail
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Nancye Feistritzer
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Shea Polancich
Affiliation:
Department of Community Health, Outcomes, and Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
*
A2200 Medical Center North, 1161 21st Avenute South, Nashville, TN 37232 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 11 , November 2014 , pp. 1383 - 1390
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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. 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.Google Scholar
2. Kassakian, SZ, Mermel, LA, Jefferson, JA, Parenteau, SL, Machan, JT. Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients. Infect Control Hosp Epidemiol 2011;32(3):238–243.Google Scholar
3. Hoffmann, C, Buchholz, L, Schnitzler, P. Reduction of needlestick injuries in healthcare personnel at a university hospital using safety devices. J Occup Med Toxicol 2013;8(1):20.CrossRefGoogle Scholar
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):20–22.Google Scholar
5. St Germaine, RL, Hanson, J, de Gara, CJ. Double gloving and practice attitudes among surgeons. Am J Surg 2003;185(2):141–145.Google Scholar
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):325–330.Google Scholar
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.Google Scholar
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):615–618.CrossRefGoogle ScholarPubMed
9. Black, L. Chinks in the armor: percutaneous injuries from hollow bore safety-engineered sharps devices. Am J Infect Control 2013;41(5):427–432.CrossRefGoogle ScholarPubMed