Why states continue to pass laws for safer needles
One-quarter of HC facilities used no safe needles
Are state laws necessary to promote the use of safer needle devices? A Maryland task force studied that question and concluded that they are.
A survey of 91 health care facilities conducted in October 1999 by the Study Group on Health Care Worker Safety showed that 24% did not use any "engineered sharps injury protection devices." Two-thirds of those not using safer devices were long-term care facilities.
Yet the use of safer technology often didn’t target the greatest risks to health care workers. Faci lities often limited their implementation of safer devices to IV systems, while data from the Centers for Disease Control and Prevention in Atlanta show that 62% of needlesticks occur with hollow-bore needles.1
"The needleless IV tubing is the easiest to implement, but it’s not where most of the risks are," says Liza Solomon, MHS, DrPH, chair of the study group and director of AIDS Administration. "I think people [on the task force] were disturbed at how few safety engineered needles were being used."
Report says regulations aren’t enough
The task force also took into account the new directive of the U.S. Occupational Safety and Health Administration and the regulatory activities of Maryland’s occupational safety agency. Again, the members concluded that current regulations aren’t strong enough to prompt a shift to safer devices.
"One of the problems with the compliance directive is that it is open to interpretation and litigation," says Solomon, noting that the OSHA directive guides inspectors when they issue citations. "[With a tougher directive,] we’re changing the threshold, but it’s not as black-and-white as legislation is."
Finally, the task force determined that the overall cost of safer needle devices wouldn’t be prohibitive because the devices would decrease other costs associated with needlestick injuries.
After the report was presented to the Legislature in January, bills modeled on California’s landmark safe needle law were introduced. Solomon says she expects broad support for the legislation because various "stakeholders" in the safe needle issue, such as the Maryland Hospital Association, were included in the study group.
Although the study group focused only on Maryland, the state’s experience is likely mirrored in other parts of the country, notes Solomon.
"I would have no reasons to think Maryland would be different from [similar] states. Maryland is a state with good health and safety laws," she says. "If we haven’t been able to implement it, I’d be surprised if anyone else has."
(Editor’s note: A copy of the Study Group on Health Care Worker Safety report is available on-line at www. dhmh.state.md.us/html/reprtk10.htm.)
Reference
1. National Institute for Occupational Safety and Health. NIOSH Alert: Preventing Needlestick Injuries in Healthcare Settings. DHHS (NIOSH) Pub. No. 2000-108. Washington, DC: NIOSH; 1999.
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