Ouch! New needlestick legislation will mean paying more for safer needles
Fewer sharps injuries predicted to bring overall savings, however
Get ready. As early as the year 2000, same-day surgery programs may face new federal requirements to implement the use of needleless systems and other safety measures designed to prevent sharps injuries.
And it will cost you. How much? About $71,000 more per year for an average 300-bed hospital converting to safer syringes and needles, blood collection devices, and IV catheters, says Kevin Seifert, director of business development and policy for Becton Dickinson (BD), the largest worldwide manufacturer of conventional and safety devices, based in Franklin Lakes, NJ.
A safer needle costs an average of 23 cents to 24 cents more than its conventional counterpart, according to an internal report from California Occupational Safety and Health Administration (CalOSHA) Standards Board. The Health Care Worker Needlestick Prevention Act of 1999 (HR 1899), a bill to reduce the risk of transmission of bloodborne diseases via needlestick injuries, is modeled after a California law implemented this summer.
Standards board staff estimate that the Cali-fornia law will cost that state’s health care facilities about $104 million a year for safer needle technology and $81 million a year for increased record-keeping costs related to sharps injury logs. The cost to a hospital of each needlestick is estimated to be between $2,234 and $3,832, according to CalOSHA. The agency estimates the savings on screening and treatment for sharps injuries at $291 million, for a net savings of $106 million per year.
"We need to consider the overall cost, and sometimes that can be a challenge," says Sally Scheurman, RN, BSN, patient care manager for Outpatient Surgery at Scripps Mercy Hospital in San Diego. "You have to consider not only the cost of new products and inservicing, but consider that cost is offset by the reduction of needlesticks and injuries to the staff and physicians."
Mary Lynne Weemering, RN, MSN, CNOR, CNS, director of surgical services at Pomona Valley Hospital Medical Center in Pomona, CA, says, "What’s important there is that needleless systems, syringes with protective sheaths, and those kinds of things cost hospitals more money to buy, so you’ve got the issue of having to spend more money in order to be safer."
The problem of sharps injuries is widespread, according to Rep. Pete Stark (D-CA), who says an estimated 800,000 needlesticks occur each year among 5.6 million health care workers. Needle-sticks carry the potential for contracting diseases such as AIDS and hepatitis.
The cost is an issue for some hospitals and same-day surgery programs, Weemering acknowledges. "They may be reluctant to spend more money for something that’s safer. But it’s important for employee health and safety that you spend that extra money."
Other states agree and are joining the effort to reduce needlestick injuries. Fourteen states and the District of Columbia have introduced legislation, and three more states are expected to introduce bills. (See chart, inserted in this issue.)
At the national level, The Health Care Worker Needlestick Prevention Act of 1999 (HR 1899) is sponsored by Stark and Rep. Marge Roukema (R-NJ). A companion bill is sponsored in the Senate (SB 1140) by Barbara Boxer (D-CA). (See summary of federal bill, p. 116.) The House bill currently has 110 co-sponsors. At press time, Stark’s office was pushing for a hearing in September or soon after.
What to expect at federal level
So what can you expect in the way of national legislation?
The House bill amends OSHA’s bloodborne pathogens standard to require that health care providers use needleless systems and sharps with engineered sharps protections to prevent the spread of bloodborne pathogens in their workplace. [For information on National Institute for Occupational Safety and Health (NIOSH) guidelines for use of sharps boxes, see Same-Day Surgery, April 1998, p. 56.]
There is currently no uniform collection of data on sharps injuries to enable needlesticks and other sharps injuries to be tracked, learned from, and prevented. The bill would require providers to keep a sharps injury log containing detailed information about any sharps injuries that occur. The bill would establish a new clearinghouse within the NIOSH to collect data on engineered safety technology designed to help prevent the risk of needlesticks and other sharps injuries. NIOSH would have access to the sharps injury logs in order to carry out these duties. The clearinghouse would also create model-training curriculum for employers and health care workers.
On the same day the national legislation was introduced, the Occupational Safety and Health Administration (OSHA) announced plans that would accomplish essentially the same goal. OSHA’s plans include three elements:
• bolstering contaminated sharps injury reporting by requiring all those injuries to be recorded on OSHA logs;
• revising the bloodborne pathogens compliance directive later this year to reflect the newer, safer technologies now available;
• taking steps to amend the bloodborne pathogens standard by placing needlestick injuries on its regulatory agenda this fall.
So what should you be doing in the meantime?
Prepare for the fact that you’ll have to keep a sharps injury log, California SDS managers advise.
"That simply means the employee health nurse or someone in the facility has to do record keeping, and it has to maintained for five years," Weemering advises. "Any time OSHA or some organization says, let me see your sharps injury log,’ you must be able to produce it."
Also, be prepared to test a significant number of new products as part of the requirement to use needle devices with engineered sharps injury protection, California SDS managers advise. (See story on types of technology being used in California, p. 117.)
Don’t forget to educate your staff on the new equipment, California managers advise. "When we come out with retractables needle sheaths, there are inservices on how to use each device," Scheurman says. "We’ve had inservices on needleless IV tubing. It’s almost product by product."
Also educate your staff about safer work practices, Weemering advises. Teach them not to put their hands in the sharps containers, for example, she says. Her facility also follows the Association of OR Nurses’ recommended practice for handling sharps. (See excerpt, p. 115.) "For example, during surgery, we’re not supposed to hand a scalpel to physicians," Weemering says. "We’re supposed to lay it in a neutral zone and let him pick it up."
Educating the staff and implementing safer devices have paid off for Pomona Valley. "We’re seeing a 50% reduction in needlestick injuries over the last several years," Weemering says.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content