Get to the point with needlestick safety

By: May 20th, 2014 Email This Post Print This Post

The following is the first of an occasional series of guest blogs by experts in the medical clinic safety field.

Rita did not place the top on the sharps container when she replaced it in the morning. Later, she threw a Gram stain slide into the container from a distance, and the slide shattered. Pieces of glass and what she felt was wet material flew into Rita’s eye.

Jason accidentally threw out the tube of blood before pouring off all of the send-out tubes of serum he needed. He thought it was safe to reach into the sharps container since he had gloves on. He pulled his hand out quickly when he felt a sudden pain, and he noticed an open bleeding cut through his glove.

Jane was busy and did not have time to replace the wall sharps container next to the phlebotomy chair when she noticed it was full. After the next patient, she activated the needle safety device and tried to shove it into the sharps container even though its safety lid was blocking her efforts. Jane pushed hard to dispose of the needle, and she felt a stinging sensation in her finger when she “succeeded.”

Sharps safety is no small matter. In the above scenarios, the incidents are particularly unsettling because each of those exposures is from unknown sources. There is no way to tell which patient is the exposure source, so it must be assumed the source is infectious. No exposure incident is good, even if the source is known and tested to be negative for HIV and Hepatitis. An unknown source exposure, however, may mean treatment with prophylactic drugs which can have unpleasant physical side effects. There is also follow-up testing and emotional impact for the employee while waiting (up to a year or more) to see if any infectious diseases were contracted.

Be sure to train lab staff properly about sharps safety. Proper activation of safety needle devices should be a part of that training. The correct placement and use of sharps containers is vital as well. Be sure floor or counter-mounted containers are prevented from tipping. Make sure lids are correctly in place in order to prevent splash-back or to keep hand and fingers out. Teach staff never to dig through a sharps container, and to always empty them before they are full.

Sharps safety should be an important piece of your lab’s Bloodborne Pathogens program, staff education on the topic should be regular. Make sure lab staff gets the point … of sharps safety!

Dan Scungio, MT (ASCP), SLS, also known as “Dan the Lab Safety Man,” is a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.

Comments

By Jon Rudin on May 21st, 2014 at 1:14 pm

A couple questions come to mind.

1. In an operating room, I have seen sharps containers with lids half covering the top sitting on the floor next to the anesthesia station. Is this placement OK and is the lid only partially covering the top OK?

2. I have never heard of the concept of emptying sharps containers, full or otherwise. My awareness has always been to close and seal shut sharps containers when the fill line has been reached and store in a secure area until picked up. Dan Scungio’s article states that sharps containers should always be emptied before they are full. Any comments?

By Jessica Eiss on May 21st, 2014 at 2:57 pm

Could we believe he meant to say contain or to secure it, instead of empty it, by means of the safety top?

By Dan Scungio on May 21st, 2014 at 5:35 pm

1. The best practice for floor sharps containers is to have the lid completely in place. However, this may prevent placing larger objects inside. If part of the lid must be left open, it should be the smallest side that is left open.

2.I should have stated that sharps containers should be replaced before full. The word “emptied” was misleading. My apologies.That would not be safe!

 

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