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Issues in Understanding the Impact of the Needlestick Safety and Prevention Act on Hospital Sharps Injuries

Published online by Cambridge University Press:  02 January 2015

Elayne Kornblatt Phillips ,
Mark Conaway ,
Ginger Parker ,
Jane Perry  and
Janine Jagger
Elayne Kornblatt Phillips*
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, Virginia School of Nursing, University of Virginia, Charlottesville, Virginia
Mark Conaway
Affiliation:
Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
Ginger Parker
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Virginia, Charlottesville, Virginia
Jane Perry
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Virginia, Charlottesville, Virginia
Janine Jagger
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, Virginia
*
University of Virginia, School of Nursing, PO Box 800782, Charlottesville, VA 22908-0782 ([email protected])
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Abstract

Objective.

Measuring the effect of the Needlestick Safety and Prevention Act (NSPA) is challenging. No agreement exists on a common denominator for calculating injury rates. Does it make a difference? How are the law and safety-engineered devices related? What is the effect on injuries and costs? This study examines those issues in assessing the impact of the legislation on hospital worker percutaneous injuries.

Methods.

Using a historic prospective design, we analyzed injury data from 85 hospitals. Injury rates were calculated per 100 full-time equivalents, 100 staffed beds, and 100 admissions each year from 1995 to 2005. We compared changes for each denominator. We measured the proportion of the injury rate attributed to safety-engineered devices. Finally, we estimated a national change in injuries and associated costs.

Results.

For all denominators, a precipitous drop in injury rates of greater than one-third (P<.001) occurred in 2001, immediately following the legislation. The decrease was sustained through 2005. Concomitant with the decrease in rates, the proportion of injuries from safety-engineered devices nearly tripled (P <.001) across all denominators. We estimated annual reductions of more than 100,000 sharps injuries at a cost savings of $69-$415 million.

Conclusions.

While the data cannot demonstrate cause and effect, the evidence suggests a reduction in hospital worker injury rates related to the NSPA, regardless of denominator. It also suggests an association between the increase in safety-engineered devices and the reduction in overall injury rates. The decreases observed translate into significant reductions in injuries and associated costs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 9 , September 2013 , pp. 935 - 939
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1. Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens: final rule, 29 CFR §1910.1030, 56 Federal Register 2235, 64004-64182 (1991).Google Scholar
2.Doebbeling, BN, Vaughn, TE, McCoy, KD, et al. Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk? Clin Infect Dis 2003;37:1006–1013.CrossRefGoogle ScholarPubMed
3.Panlilio, AL, Orelien, JG, Srivastava, PU, Jagger, J, Cohn, RD, Cardo, DM. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998. Infect Control Hosp Epidemiol 2004;25:556–562.Google Scholar
4.Jagger, J, Perry, J, Gomaa, A, Phillips, EK. The impact of U.S. policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices. J Infect Public Health 2008;1:62–71.CrossRefGoogle ScholarPubMed
5. Needlestick Safety and Prevention Act, 114 CFR §106-430, 1901 (2000).Google Scholar
6. Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; needle-sticks and other sharps injuries; final rule, 29 CFR §1910.1030, 66 Federal Register 12, 5318-5325 (2001).Google Scholar
7.Phillips, EK, Conaway, MR, Jagger, JC. Percutaneous injuries before and after the Needlestick Safety and Prevention Act. NEngl I Med 2012;366:670–671.Google Scholar
8.Billiet, LS, Parker, CR, Tanley, PC, Wallas, CW. Needlestick injury rate reduction during phlebotomy: a comparative study of two safety devices. Lab Med 1991;22:120–123.CrossRefGoogle Scholar
9.Younger, B, Hunt, EH, Robinson, C, McLemore, C. Impact of a shielded safety syringe on needlestick injuries among healthcare workers. Infect Control Hosp Epidemiol 1992;13:349–353.CrossRefGoogle ScholarPubMed
10.L'Ecuyer, PB, Schwab, EO, Iademarco, E, Barr, N, Aton, EA, Fraser, VJ. Randomized prospective study of the impact of three needleless intravenous systems on needlestick injury rates. Infect Control Hosp Epidemiol 1996;17:803–808.Google Scholar
11.Centers for Disease Control and Prevention. Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures— New York City, March 1993-June 1994. MMWR Morb Mort Wkly Rep 1997;46:25–29.Google Scholar
12.Zakrzewska, JM, Greenwood, I, Jackson, J. Introducing safety syringes into a UK dental school: a controlled study. Brit Dent 2001;190:88–92.CrossRefGoogle ScholarPubMed
13.Parker, G, Perry, J, Jagger, J. EPINet report: 1999 percutaneous injury rates. Adv Exposure Prev 2002;6:7–8.Google Scholar
14.Sohn, S, Eagan, J, Sepkowitz, KA, Zuccotti, G. Effect of implementing safety-engineered devices on percutaneous injury epidemiology. Infect Control Hosp Epidemiol 2004;25:536–542.CrossRefGoogle ScholarPubMed
15.American Hospital Association (AHA). AHA hospital statistics, 1995-2005. Chicago: AHA.Google Scholar
16. US Census Bureau. Reference resources for understanding Census Bureau geography: census regions and divisions of the United States, http://www.census.gov/geo/www/reference.html. Accessed December 27, 2011.Google Scholar
17. US Department of Agriculture, Economic Research Service. 2003 rural-urban continuum codes. http://www.ers.usda.gov/Data/RuralUrbanContinuumCodes/2003/. Accessed December 27, 2011.Google Scholar
18.Hogan, A. Gaps and successes of safety device market conversion. Mater Manag Health Care 2005;14:33–34.Google Scholar
19. US Department of Labor Bureau of Labor Statistics. Injuries, illnesses, and fatalities. http://www.bls.gOv/iif/#data. Accessed July 13, 2012.Google Scholar
20.Perry, J, Jagger, J. OSHA enforcement activity on BPS: an update. http://www.mlo-online.com/articles/0308/0308special_feature.pdf. Accessed April 13, 2012.Google Scholar
21. Standard precautions in hospitals. In: Betsy Lehman Center for Patient Safety and Medical Error Reduction, JSI Research and Training Institute. Prevention and control of healthcare-associated infections in Massachusetts. Pt 1. Final recommendations of the expert panel. Boston: Massachusetts Department of Public Health; 2008:42-49. http://guideline.gov/content.aspxfid = 12917. Accessed April 15, 2013.Google Scholar
22. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program, http://www.cdc.gov/sharpssafety/resources.html. Accessed April 17, 2013.Google Scholar
23. US General Accounting Office. Occupational safety: selected cost and benefit implications of needlestick prevention devices for hospitals, GAO-01-60R (2000).Google Scholar