For many surgeons, nurses and techs, sharps safety is merely preventative, another necessary precaution in a long line of necessary-but-onerous precautions that are just part of the job. But for Brenda G. Larkin, MS, RN, ACNS-BC, CNS-CP, CSSM, CNOR, clinical nurse specialist with Aurora Health Care in Elkhorn, Wis., sharps safety is personal.

Back in the early 1990s, before the emergence of neutral zones, Ms. Larkin suffered a sharps injury during an orthopedic procedure when a resident absentmindedly placed a needle on the mayo stand. Ms. Larkin, who also serves on the AORN board of directors, reached onto the mayo stand and wound up getting stuck. She received multiple screenings for HIV and Hepatitis B and C, and had to wait a full six months to find out she was infection-free. “I was basically in limbo that whole time,” says Ms. Larkin. “It was emotionally and mentally draining.”

This harrowing experience no doubt impacted Ms. Larkin’s approach to sharps safety at Aurora — an approach that is quite robust. Staff adhere to using a neutral zone — a designated area where sharps must be placed and received — and double-glove with an outer- and inner-glove indicator system. When the white outerglove it pierced or torn, the color of the underglove shows through, letting staff know to switch to a fresh pair.

In addition, surgeons use safety scalpels and the surgical team uses safety needles when they perform injections in the sterile field. “We’ve been using safety scalpels since 2010, and we added safety needles a little more recently,” says Ms. Larkin.

Finally, Ms. Larkin stays abreast of the latest sharps safety products as they hit the market, and incorporates the cutting-edge technology and best practices into her facility’s protocols whenever it’s feasible to do so.

“Staff can’t always go to conferences, so I make it a point to bring back new ideas and introduce them to nurses on the front lines,” says Ms. Larkin. If the product works and there’s staff buy-in, they move on to conducting a trial of the device.

Of course, proven best practices such as double-gloving, the neutral zone and safety scalpels need surgeon support to be effective. That’s not always easy to accomplish, especially when it comes to use of a neutral zone. The best way to get your surgeons to stick to your sharps safety protocols often comes down to giving them the “whys” behind your mandates — in as succinct a manner as possible. In other words, the more clearly (and quickly) you can explain the need for your sharps safety protocols, the more likely it is you’ll get buy-in. For her part, Ms. Larkin often uses the SBAR (Situation, Background, Assessment and Recommendation) approach to explain safety protocols because, as she puts it, most surgeons respond best to hard facts backed by clinical evidence.

Dr. Mitchell says facilities that aren’t investigating sharps safety options are at risk of violating the OSHA Bloodborne Pathogens Standard, which requires employers to evaluate commercially available engineered sharps safety controls each year. “My biggest fear for many of these facilities that aren’t adopting safer technologies is they’re not evaluating them on an annual basis, which means they’re at risk of getting an OSHA citation should they be inspected,” she says.

Surgical administrators shouldn’t feel helpless when it comes to eliminating sharps injury risks. Instead, says Dr. Mitchell, they need to leverage their injury data. “There is immediately actionable information in their sharps injury log, which they’re required to keep as part of the OSHA Bloodborne Pathogens Standard,” she says. “That log is an incredibly useful resource. From it, they know what devices are causing the injuries, during what procedures and to whom. They can use that data to address specific actionable interventions.

Using surveillance data in a way that provides a safer working environment for the entire surgical team is the best way to make real change happen.

Information from the sharps injury log that identifies the injuries and the devices causing the injuries feeds into complying with the standard, which also feeds into updating your facility’s exposure control plan.

“It’s a terrific tool immediately available at your disposal,” says Dr. Mitchell. “You can chart your annual progress in reducing sharps injuries as your surgical team adopts safer devices and experiences improvements in reducing injuries over time.” OSM