Ambulatory surgery centers are in frequent violation of needlestick and sharps safety protocols and lag significantly behind hospitals in oversight of OSHA's Bloodborne Pathogen Standard, according to AORN.

AORN says OSHA has increased facility inspections over the last 4 years and cited increasing numbers of surgery centers and physician offices for bloodborne pathogen standard violations, which AORN says make up a majority of OSHA's recent medical facility citations. In fact, facilities in Florida, Alabama, Georgia and Mississippi have recently undergone unannounced inspections from OSHA officials who focused on the processes and programs centers have in place to protect workers from bloodborne pathogens associated with exposure to contaminated sharps devices. The inspections will continue through September 2012, according to OSHA.

In a 2-part article series published in the October and November issues of AORN Journal, Pamela Dembski Hart, BS, MT(ASCP), CHSP, principal of Healthcare Accreditation Resources in Boston, Mass., says compliance with the bloodborne pathogen standard - intended to protect workers from exposure to blood or other potentially infectious materials - is key to creating a safe working environment for surgical teams.

The standard also helps protect patients, according to AORN, which claims more than 130,000 individuals treated at ASCs over the past decade were notified of potential exposure to HBV, HCV and HIV due to unsafe injection practices and lapses in infection control.

Ms. Hart's articles cited outdated or nonexistent exposure control plans, poor documentation, the failure to use safety devices and the lack of free sharps handling training during working hours as the most frequent causes of bloodborne pathogen violations. OSHA has levied the highest fines against staffs who failed to immediately remove contaminated personal protective equipment and failed to use safety devices, and against facilities that did not provide injured workers with free hepatitis B vaccination and follow up, according to AORN.

Ms. Hart advises facilities to work with their surgical staff to assess sharps and needlestick exposure risks and incorporate those findings into a documented exposure control plan in order to remain compliant with OSHA's standards.

Daniel Cook