The EXPO-STOP1 authors recommend that employee health professionals consider the following best practices to prevent needlesticks and other exposures to staff.
Education:
- Require new clinicians to demonstrate competency with all new devices.
- Discuss exposure prevention individually and in orientation in a personalized way.
- Build a bloodborne pathogen exposure event into simulation lab training scenarios.
- Use vendor support and clinical educators to “stretch” resources and provide all-shift coverage.
- Provide mandatory initial and ongoing education using a variety of methods, including online modules and face-to-face interaction with employee health and/or workers’ compensation nurse case manager.
- Require a review process and waiver for requests for non-safety-engineered devices.
Communication:
- Make initiatives data-driven, and report using metrics aligned with the organization’s goals and reporting style.
- Be transparent with findings and get them “on the record” by reporting through established committees that reach decision-makers.
- Encourage reporting (including “near misses”) by making it convenient and efficient, such as a call-in or online reporting system.
- Develop awareness campaigns to reach frontline staff.
- Use safety scripting to prepare patients for procedures that are high-risk for employee exposure, such as blood draws.
- Use flagging outside patient rooms to alert co-workers that a high-risk procedure is in progress to avoid an inadvertent startle and possible injury.
Investigation:
- “Drill Down” — Conduct a thorough, systematic root cause analysis to avoid assuming causation.
- Actively involve the manager and the injured employee in the follow-up investigation.
Engagement:
- Hold both the healthcare worker and management responsible for their roles in the “Safety Formula,” and when they do it well, praise them.
- Partner with stakeholders using safety forums for discussion. For example: “If you arrived to work today and it was a safer environment, what would it look like?”
- Include perceptions of workplace safety in employee opinion evaluation.
- Use frontline staff “Safety Advocates” partnered with employee health and administration in injury reduction initiatives.
REFERENCE
- Brown C, Dally M, Grimmond T, et al. Exposure Study of Occupational Practice (EXPO-STOP): An update of a national survey of sharps injuries and mucocutaneous blood exposures among healthcare workers in U.S. hospitals. AOHP Jrl 2016:36(1):37-42.
The Exposure Study of Occupational Practice authors recommend that employee health professionals consider best practices to prevent needlesticks and other exposures to staff.
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