3 New Ways to Improve Sharps Safety
By: Aorn Staff
Published: 10/22/2019
Publish Date: June 12, 2019
Have you or a team member ever experienced a sharps injury during perioperative care?
More than 385,000 healthcare workers in the U.S. reported a sharps injury last year. And, far more go unreported every day, especially in perioperative care areas where nurses, scrub personnel and surgeons are more likely to keep moving on with their day after a sharps injury occurs.
For surgeons, a meta-analysis and meta-regression of 45 studies by Verbeek and Basnet determined sharps injuries could happen during one in every 10 procedures.
AORN hopes updates to the Guideline for Sharps Safety will give every member of the surgical team new evidence, practice guidance, and injury response approaches based on OSHA’s hierarchy of controls to reinvigorate conversation around sharps safety, according to Mary J. Ogg, MSN, RN, CNOR, AORN senior perioperative practice specialist.
Ogg authored the original guideline in 2013 and investigated new evidence for this update.
“The research continues to demonstrate that using blunt suture needles, hands-free or neutral zone practices for sharps transfer and double-gloving reduces sharps injuries,” she says. “Yet these practices are still not standardized in many perioperative care settings.”
What’s Being Practiced
Anecdotal reports note double-gloving to be the most widely used sharps injury prevention practice, although an indicator sterile glove worn beneath a sterile glove for every surgical procedure is not as common as wearing two sterile gloves, Ogg explains. She is seeing more facilities implement hands-free and neutral zone practices for transferring sharp instruments, including needles and scalpels, between surgical procedures.
However, facilities are still slow to adopt the use of blunt suture needles for suturing tissues that do not require a sharp needle, despite the fact that suturing remains one of the most common reasons for provider injury.
“As the technology continues to advance for sharps safety, and as awareness of the risks of not practicing sharps safety continues to be understood and discussed, we hope the simple, evidence-based practices for injury prevention become more common,” she stresses.
What’s at Stake
Sharps injuries can transmit bloodborne pathogens from patient to provider. Without rapid response through employee health to conduct blood tests and assess the risk of bloodborne pathogen transmission, healthcare providers may go untreated for deadly diseases, including hepatitis C and HIV.
“The treatment for bloodborne diseases transmitted through sharps injuries can require costly and long-term medications that may not be covered through worker compensation if the injury is not reported in a timely manner and investigated through employee health,” Ogg advises. She also says perioperative providers exposed to bloodborne disease through sharps injury who don’t seek treatment risk transmitting the disease to future patients.
Three New Ways to Improve Sharps Safety
- Double-glove the right way.
The guideline update gives more specific information around double-gloving practices, including the recommended use of a perforation indicator glove under the second glove to increase awareness that a glove perforation has occurred.
A new systematic review of randomized controlled trials on double-gloving by Mischke et al cited in the update found that glove perforations were reduced by 71% when wearing two pairs of gloves compared to wearing only one.
- Implement the Hierarchy of Controls.
Through restructuring the guideline based on OSHA’s Hierarchy of Controls for addressing sharps safety, Ogg says standardized methods for managing prevention and addressing sharps injuries will be easier for any healthcare facility to adopt. This hierarchy includes recommendations for administrative controls and hazard reduction down to individual practice controls to reduce workplace injury.
“Occupational safety experts are familiar with this hierarchy of controls from OSHA so framing sharps safety in this hierarchy can create more consistent structure around safety practices, whether shaping a new policy or taking individual action to reduce sharps injury risks,” she adds.
- Model sharps safety and call out injuries.
Perioperative nurses play a critical role in advocating for sharps injury reporting and also modeling safety behavior by making the personal decision to double-glove, Ogg stresses. Nurses can advance team understanding of the guideline updates to support new education and updated policy around standardized sharps safety.
“Awareness and action are two ways every perioperative nurse can reduce the risk of sharps injury for their team members, including novice perioperative nurses and medical residents still learning about the dangers of sharps,” she adds.
Additional Resources
Comment on the updates to Guideline for Sharps Safety. Public comment is open through July 5.
Read and share the systematic review on double-gloving by Mishke et al and the risk of surgeon exposure to sharps injury by Verbeek and Basnet.
Free Resources for Members Only
Reduce the risk of sharps injury in your patients with quick step-by-step instructions, ready-to-use and customizable templates, key takeaways, and more for the guideline on Sharps Safety.
AORN Journal CNE Articles
Back to Basics: Sharps Safety (.8 CHs)
Webinars
Recommended Practices for Sharps Safety (1 CH)
Sharps Safety Tools Kit
