To Stop Needlesticks, Educate, Communicate, and Investigate

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

1. 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.