New Jersey adopts tougher needlestick law
Push continues to require safer devices
New Jersey became the fifth state to mandate use of safer needle devices, as tougher state laws on needle safety increase pressure on hospitals to evaluate and update their sharps devices. The law gives hospitals in New Jersey one year to switch to devices with "integrated safety features" that have been approved by the Food and Drug Administration.
If a suitable device doesn’t exist or if a health professional believes the safer device would compromise patient care, the hospital may file for a waiver.
The law was lauded by needle safety experts, who say such legislation creates swift improvements in the use of safer devices.
"We can see very clearly in California [the first state to pass a needle safety law] that there has been a very rapid and significant increase in the use of safety devices," says Janine Jagger, PhD, MPH, director of the International Health Care Worker Safety Center at the University of Virginia in Charlottesville. "That is directly related to the law.
"We can see that there are increases in other states where there are no laws, but not to the extent that there is in California," she says. "A law is simply stronger than the OSHA compliance directive."
The U.S. Occupational Safety and Health Administration issued an updated directive in November, calling for hospitals to review their exposure control plans annually and implement the most effective "engineering controls" to reduce needlestick injuries. The OSHA directive guides inspectors, but OSHA generally conducts inspections in response to complaints.
OSHA also is reviewing its bloodborne patho gens standard. Incorporation of device safety requirements in the standard would represent a stronger regulatory mandate.
Nationwide, the use of safer devices varies widely. For example, 63% of IV infusion sets in use incorporate safety features, compared to less than 10% of vacuum tube phlebotomy needles and disposable syringes.1 About 600,000 to 800,000 needlesticks occur each year, about half of them unreported. Safety devices have been shown to reduce needlesticks by about 80%.
Bill Borwegen, MPH, occupational health and safety director of the Service Employees Inter na tional Union in Washington, DC, called the New Jersey law the "most significant" since California passed its needlestick law in 1998.
Hawaii, Texas, and Tennessee also mandated the use of safer needle devices, but with different provisions. In Texas, the mandate covers only state and local hospitals, although the bill has spurred use of safer devices statewide, says Borwegen.
"The private sector in hospitals are buying the needles too, even though the law only covers the public sector," he says.
Legislatures in about a dozen other states are considering needle safety bills. The Health Care Worker Needlestick Prevention Act also is currently pending in the U.S. House of Represent a tives with 162 co-sponsors.
The new laws often cover reporting requirements in addition to the implementation of safety devices.
New Jersey hospitals must report any needlestick injuries, including type and brand names of devices, on a Sharps Injury Log or OSHA 200 log. The state Department of Health and Senior Ser vices will compile needlestick information and report to the Legislature.
The law also requires hospitals to establish sharps device evaluation committees in which at least half the members are "direct-care health care workers."
Reference
1. Jagger J, Bentley M. Safe disposal of safety devices. Advances in Exposure Prevention 1999; 4:13-24.
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