It’s the law: Buy safer needles, keep injury log
January 1, 2001 3 minutes read
It’s the law: Buy safer needles, keep injury log
Needlestick law may usher in sweeping changes
For 12 years, Janine Jagger, PhD, MPH, has been telling health care professionals that needles with a safety design could prevent 80% of needlestick injuries.
Now, with the signing of the Needlestick Safety and Prevention Act, Jagger, who is the director of the International Health Care Worker Safety Center at the University of Virginia in Charlottesville, can watch that dramatic shift take place nationwide.
Just as health care workers wouldn’t think of drawing blood or providing other patient care tasks without wearing gloves, Jagger envisions the day when they will be appalled to see a "conventional" needle without a safety device. But moving from law to practice may not be completely smooth. "I think getting the facilities to quickly and efficiently undertake the change once the law is in effect, that’s going to be the larger of the challenge," says Jagger. "There’s a lot of inertia at the level of the health care facilities."
Cost has been a stumbling block
Safer devices have typically been more expensive than the conventional ones, presenting a stumbling block for hospitals in financial straits. However, group purchasing organizations are now including more safety devices among their inventory, and manufacturers are improving both the availability and quality of their designs, say Jagger and others.
For example, Premier Inc., an alliance of hospitals and health systems based in Chicago, awarded new group-purchasing contracts to substantially expand its choices of safety devices.
"There are going to be ripple effects continuing to occur here," says Bill Borwegen, MPH, occupational health and safety director of the Service Employees International Union in Washington, DC.
Safety device supply shouldn’t be a serious problem, as it was initially when California’s landmark needle safety law went into effect in 1999.
"The manufacturers are about as prepared as they can be for this," says Jagger, although she adds, "With such a massive change ahead, there is going to be some level of challenge along the way."
About 17 states had passed individual laws mandating the use of safer needle devices. In November 1999, the Occupational Safety and Health Administration (OSHA) issued a compliance directive, saying that hospitals should use the best available safety devices and update an exposure control plan yearly.
The new law goes further, providing for involvement of frontline workers in the evaluation and selection of devices and requiring the maintenance of a needlestick log.
The law directs OSHA to revise its bloodborne pathogens standard. The new standard will become effective 90 days after it is published in the Federal Register, which should occur in about six months. In the interim, "OSHA has been pretty aggressive in citing people for failing to purchase safer needles under the compliance directive," says Borwegen. "[The law] basically codifies the compliance directive."
While the law will speed up the move to safer devices, it will take time for hospitals to evaluate and implement them throughout their facilities, notes Gina Pugliese, RN, MS, director of the Premier Safety Institute. "Very few hospitals have a safety device in place everywhere there’s a sharp," she says. "But it’s important to have a plan [for compliance] and be working on the plan."
Watch out for JCAHO
The greatest impact could come from surveyors with the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL. The Joint Commission requires hospitals to comply with all applicable laws and regulations. While Jagger says she would have preferred to see the Joint Commission provide more of a leadership role on this issue, she notes that the accrediting body could carry significant weight.
Meanwhile, the push for state laws hasn’t ended with the federal law. It doesn’t apply to facilities not covered by federal OSHA, such as public hospitals. "If state laws are more comprehensive in covering the institutions in their state, that would be an important role for state legislation," says Jagger.
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