Congress passes landmark needle-safety legislation
Hospitals must use safer devices, keep log
Using safer needle devices and documenting all needlesticks on a sharps injury log became a national legal mandate with passage in late October of the Needlestick Safety and Prevention Act in the waning hours of the congressional session.
Needle-safety experts and union representatives predicted that the new law would prevent thousands of needlesticks. When used properly, safety devices can reduce needlestick injuries by 80%.
"This landmark legislation without a doubt will save many lives and improve the quality of health care," said Janine Jagger, PhD, MPH, director of the International Health Care Worker Safety Center at the University of Virginia in Charlottesville, who was among the first to call for the use of needle safety devices.
The bill, approved unanimously by both the House and Senate, was one of the last actions taken before Congress adjourned in late October. President Clinton was expected to sign it into law in November.
The Needlestick Safety and Prevention Act amends the bloodborne pathogen standard of the U.S. Occupational Safety and Health Administration (OSHA), bypassing the lengthy process of rule making. In 1999, OSHA already had issued a compliance directive directing hospitals and other health care facilities to use "engineered controls" to reduce needlesticks.
The revised bloodborne pathogens standard, as provided by the law, will become effective 90 days after it is published in the Federal Register, which should occur in about six months.
The Needlestick Safety and Prevention Act requires employers to take these measures:
- Use devices designed with safety features and maintain an up-to-date exposure control plan.
- Include nonmanagerial workers who are involved in direct patient care in the evaluation and selection of devices.
- Maintain a sharps injury log with information on the type and brand of device involved in the incident, the work area where the exposure occurred, and an explanation of the incident.
"This was a very dramatic bipartisan effort," says Madeleine Golde, senior legislative advocate for the Service Employees International Union in Washington, DC. "This bill could never have passed without that."
The law may stem a wave of state legislation on needlestick prevention, which began with landmark legislation in California. Some 16 states had passed some type of needle safety law. The national legislation was endorsed by the American Hospital Association.
Yet despite widespread support for the needle safety bill and intense lobbying by unions representing health care workers, the bill was stalled for a time by political machinations.
When the bill passed the House and went to the Senate, Sen. Jim Bunning (R-KY) put a procedural "hold" on it. MedPro, based in Lexington, KY, a manufacturer of sharps safety equipment, was pressing for language in the bill that would incorporate needle disposal devices. Bunning eventually removed that hold.
"They completely misunderstand the difference between a safer device and a disposal device," lamented Mary Foley, RN, MS, president of the American Nurses Association in Washington, DC.
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