Preventing sticks: Safety devices aren’t enough
Training, safety climate also reduce injuries
The data aren’t out yet on how many needlesticks are being prevented through safer devices. But researchers already know one thing: Devices are only one part of the solution. Em-ployees and administrators are the other part.
Proper training and a commitment to safe practices are essential to a successful needlestick prevention program, occupational health experts say.
Robyn Gershon, MHS, DrPH, associate professor at the Mailman School of Public Health at Columbia University in New York City, is testing an innovative, computer-based training program that presents employees with simulations based on actual needlestick scenarios.
"These simulations make it real. They are real," she says. "You have to make decisions along the same path as the person who had the [needlestick] experience."
This training won’t replace the annual bloodborne pathogen inservice or the specialized training in using specific devices. But it will help employees overcome negative attitudes toward switching to safety devices and bad habits, such as recapping or failure to use hands-free passing in the operating room.
"This is really [intended] to change the para-digm, to change the thought process," she says, noting that the program will include Internet chat rooms and a toll-free number for employees who have questions. It also will provide continuing education units.
The program currently is being tested with 5,000 nurses, including a comparison group who will receive traditional bloodborne pathogen training. The study will use questionnaires to measure employee knowledge, perceptions, attitudes, behavioral intentions, current safety practices, and recent past history of exposures before the training and at three and six months afterward. If the program proves to be an effective educational tool, it will become widely available.
Even after implementing safer devices, em-ployee health professionals will continue to seek ways to reduce needlesticks, Gershon says. "This is a way to help facilitate the reduction of risk one step further," she says.
Meanwhile, Marion Gillen, RN, MPH, PhD, assistant professor at the University of California School of Nursing, is still compiling five years of data to determine the impact of that state’s needle safety law, the first in the nation. The project includes data from two years before the effective date of new regulations. Gillen and colleagues also conducted site visits to 79 of California’s 400 hospitals.
"In general, we found that people are making really good progress," says Gillen, who expects to have results from the study by the end of the year. "There are certain things that I think people had trouble with and didn’t understand.
"If the standard [states that] in the sharps injury log that you have to collect data on these 10 points, some facilities didn’t really understand that they really had to get all 10. So they didn’t have all of the information."
Gillen is also collecting information on nurses’ perception of the hospital’s overall safety climate. She expects to find a relationship between the safety climate and needlesticks, as Gershon has in previous research.
"We’ve looked at the compliance issues before, and we found safety climate was the single most important factor," says Gershon.
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