Worker’s comp insurer mandates sharps program
SC trust helps hospitals with injury prevention
Hospitals in South Carolina have an imperative to adopt safer needle technology that is even stronger than federal regulation: Their workers’ compensation insurer demands it.
The board of directors of the Palmetto Hospital Trust in Columbia, a self-insurance pool that covers 65 acute care hospitals and other health care facilities, voted unanimously to adopt new underwriting guidelines that require members to implement a "sharps injury prevention program."
While the trust hasn’t suffered a significant liability from needlestick injuries, the potential exists for high costs from just one claim, says Chip Wise, MHA, assistant vice president for business development of PHT Services Ltd., the administrative arm of the trust.
"There is definitely a great deal of concern about the future," says Wise. "The potential is there for a claim to be very devastating."
A single seroconversion of hepatitis C in an injured worker could lead to workers’ compensation costs of $500,000 to $1 million, he says.
Money isn’t the only motivation. The trust also recognizes a moral obligation to promote the well-being of health care workers, says Wise. The trust created a Health Care Workers Safety Center to provide education and information, support research, and conduct surveillance.
"We would like to be a resource of clinical data," says Wise. "If a client wants to implement a safety syringe, what are some of the success stories [in other facilities]?"
The Palmetto Hospital Trust didn’t set a time line for implementing a sharps injury prevention program. Rather, the trust administrators plan to work with the hospitals collaboratively. They are also developing criteria to define an "effective" program.
An initial survey showed wide variation in the use of safer technologies. Some hospitals already have a sophisticated program for evaluating and implementing new devices, while others have just taken initial steps toward safer technology.
"We expect within two years that we should see a substantial change in South Carolina with [safer technology in our client facilities," he says. "I think we’ll see dramatic progress in the use of safer processes and equipment."
PHT hospitals already had been working on needlestick prevention. In 1992, 40 PHT hospitals joined EPINet and worked with the International Health Care Worker Safety Center at the University of Virginia to incorporate safer devices. From 1993 to 1997, sharp object injuries declined by 37%.
Now, the trust is emphasizing better reporting of injuries by all members through the EPINet system, which provides a "Uniform Needlestick and Sharp-Object Injury Report" and "Uniform Blood and Body Fluid Exposure Report." All hospitals will have a Windows-based version of the EPINet software, allowing better in-house tracking and reporting to the national database.
That puts South Carolina hospitals just ahead of the curve, as more complete reporting of sharps injuries is likely to become mandatory for hospitals nationwide. The California safe needle device legislation, passed in 1998, included reporting requirements, as does recent New Jersey legislation. (See related article below.) The U.S. Occupa tional Safety and Health Admi nistration has indicated that its pending recordkeeping standard will include stricter reporting requirements.
"Good records — effective tracking — is the first step before you can address the problem," says Wise. "You have to know where your exposures are occurring."
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