Notes from the field: Why doesn’t that needle have the safety feature engaged?

By: February 24th, 2011 Email This Post Print This Post

When I do a mock OSHA inspection, I always look at the sharps containers. I check to make sure discarded sharps items have not exceeded the fill line. If the sharps container is clear, I can easily see what’s inside. Otherwise, I try to look down into the container.

I look for scalpels that do not have sheaths over the blades, non-retractable lancets, and needles that are non-safety engineered.

On a recent inspection, I knew that the practice I was inspecting was using all safety devices, so what I found was very surprising!

When I inspected the first exam room, the sharps container held all safety needles. BUT, the safety feature had not been engaged on the majority of the needles.

I waited to question what I saw until I looked at other exam rooms. Every needle looked the same. This particular safety device was the type that you used your thumb to click the safety feature down over the needle.

The office manager was as puzzled as I was. We questioned every employee and they claimed to have properly used the needles by engaging the safety features.

We decided to inform the physician that we had a problem with someone in the office. When I reviewed my findings with her, the physician sheepishly said, “I had no idea I was supposed to click that thing on the needle.”

I asked her if she realized what the intent of the safety device was, and she replied that she thought she was exempt from using it as intended.

My inspection turned into an educational session with the physician. I informed her that as an employee of her practice, she must comply with proper use of all safety devices. We also held a demonstration class for the physician and the entire staff on the proper technique for using all safety devices in the office.

Remember, you may use a non-safety needle to draw up medication and switch to a safety needle to give the injection. In this case, you should document this practice in your Exposure Control Plan along with your policy for how it is disposed and capped, so there is no misunderstanding should an OSHA inspector peer into your sharps container.

Comments

By Vicki Hardman on February 24th, 2011 at 3:41 pm

i have been told that I have the option to use non safety glide syringes. i have tried the safety glide syringes and i do not like them. I actually stuck myself trying to click it over the needle. I just want to make sure this is ok and what I need to do to be in compliance

By Carol Hutchinson on February 24th, 2011 at 4:27 pm

Can you tell me where, in the BBP Federal Standard, that it states you must use a safety device, and that you must engage it if you are immediately placing the needle or scalpel directly into a sharps container. I am trying to enforce this but am often told it is safer to put the needle/syringe or scalpel immediately into a sharps container if it is located within arms reach.

By Kathy Rooker on February 27th, 2011 at 7:50 pm

The Bloodborne Pathogens Standard is
29-CFR. The regulations are under 1910.1030. Using a safety needle is NOT optional. Engaging the safety falls under engineering controls. You must activate the safety on the device immediately after removing the needle from the patient. (not while walking to the sharps container) If there is a particular safety needle you do not like, you must evaluate others until you find one you feel comfortable using. The intent of the Needlestick Prevention and Safety Act, is that you switch to safety devices. If OSHA stops in your office, and you are not using safety needles, you will be fined!

I had an experience recently where I presented to an urgent care clinic to receive a tetanus shot.

Upon completing the injection, the tech walked away from me with his hand up high in the air holding the syringe with uncapped needle. He then placed the syringe in the sharps container.

When I asked the tech about this practice, he told me that this was his safety procedure for those instances when he didn’t want to take the time to go looking for the safety needles.

 

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