Notes from the field: “Doctor, please, say no more!”

By: September 13th, 2010 Email This Post Print This Post

In addition to doing mock OSHA Inspections, I provide annual OSHA training to physicians and their staff. Last week I was in an office that did not have any safety needles, lancets, or scalpels.

As a part of my training, I talked about using safety devices. I reminded them that OSHA has required using safer sharps since July 18, 2001. This physician was very aware of the requirements, but had never purchased safety devices or requested samples from his vendors. I talked about exploring safety devices, doing an evaluation, and implementing safety devices that the staff and physician agreed would provide the best protection against injuries.

The physician was sitting beside me and said in a loud voice that he did not get additional reimbursement to cover these devices, and therefore had no intention of buying them. He said they were just “too expensive!” I leaned over and told him that I would like speak to him privately after the class. He just wouldn’t stop expressing how he couldn’t afford to buy the safety needles. His nurse spoke up and said she had been asking him for years to order safety lancets for fingersticks. I finally offered to contact a vender to drop off samples of safety needles and lancets for the staff to evaluate.

After the training class, the nurse came up to me and said she was thinking about calling OSHA on her “boss”. I encouraged her to try the safety devices that were being ordered and I told her I would talk to the physician.

I informed him how upset his nurse was and how very expensive OSHA fines were. Cost cannot be a factor for refusing to implement safety needles. I reminded him that how costly and life threatening a needlestick injury could be if his staff contracted hepatitis or HIV.

I finally convinced him to follow through with the vendor and do an evaluation and order safety devices ASAP. He will be very lucky if OSHA doesn’t stop by for an inspection. A serious employee complaint will usually bring them to your office.

Comments

Kathy,

Nice post, great reminder that not all healthcare facilities are keeping their workers safe. Hope the Doc has a change of heart and realizes that he has created a ticking time bomb and that his employees are well worth the investment of safer devices.

Rick
Joey SprayGuard

Kathy, Very nice work! As in the past the docs are the last to jump on board. It’s always the nurse or other staff that puts themselves at risk just for a job!!

By Nyla Japp, RN, PhD on September 14th, 2010 at 2:26 pm

Kathy,
Do you have any suggestions on how we get the OR to be more careful with their sharps. It’s not that the safety needlebox is not provided, the OR simply “forget” to use them. Needle sticks in our healthcare facilities sterile processing departments are hugely unreported and would like to see more enforcement from our OSHA Inspectors. The Joint Commission is not getting to this problem. Any ideas?
Thanks,
Dr. Japp

By Jane O'Connor on September 14th, 2010 at 5:04 pm

Thank you Kathy,
I am interested in knowing what other organizations are doing with scalpels. What brands are being used and especially for left handed surgeons.
Thanks, Jane

Does OSHA consider needleless IV connector one of the mandatory safety devices?

Interesting story in the fact that this is more common than we might realize. This is a story that is repeated many times a day. Staff know what is needed but it is not bought. Some are affraid if they say somethig that they could loose thier job.

Not just with these items but many other items.

Dr. Japp asked a very good question.

This doctor’s nurse should have called OSHA a long time ago on this guy. If he’s so careless with his staff’s safety, what kind of risks is he exposing his patients to on account of his flippant and mercenary attitude?

I just got done inspecting a small facility. They had safety IV needles, needless IV systems and safety lacets, but not a single safet hypodermic, scalpel or blunted suture needle. No sharps safety program was in place.

And they had just had a CMS (medicare) inspection a few months earlier. They did not comment on this at all.

By Kathy Rooker on September 22nd, 2010 at 1:49 pm

Dr. Japp I understand your frustrations!! I see facilities every week that are not using safety sharps.For those offices that have problems with the staff using the provided safety sharps and proper disposal techniques,I recommend re-educating the staff with OSHA training. Everyone documents they have been given the training.From that day forward, the staff must follow the OSHA Exposure Control Plan. If they chose not to use the safety sharps or properly dispose of used sharps, I recommend that you start progressive counseling and ultimate termination. These employees are putting your facility at risk for very expensive OSHA fines. It is the facility that will incur the fines, not the employees. Keep in mind, ALL needle sticks must be reported to the Safety Officer.

By Kathy Rooker on September 22nd, 2010 at 2:15 pm

LC, All devices used to start an IV must be “safety engineered”.

 

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