SAFETY DEVICES – How Safe is Safe
Dealing with the healthcare of people, management of critical care and emergencies in itself is a task that calls for utmost sensitivity and attention. In this process, the responsibilities and responsiveness of medical devices used in both diagnosis and therapy can never be over emphasised. What with complex ailments and changing disease patterns, innovative technologies, the expectations and dependence on medical devices is ever increasing. As a result, these devices are supporting more and more with patients who in turn risk their lives to a great extent on the ability of these silent partners to deliver accurate diagnostic reports; provide appropriate and adequate therapy; perform indefatigably; and finally offer a safe interaction and outcome.
?Legislation for the requirement for healthcare facilities to adopt safety devices and engineering controls is in effect over the past two decades. The current requirements compel healthcare facilities to document the input solicited from non-managerial staff in identifying, selecting, evaluating and implementing these safer devices, and to maintain a sharps injury log for recording exposures.
As regards "Engineering Controls" for example, the `Bloodborne Pathogen Standard of 2001’ defines engineering controls as "controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices such as sharps with engineered sharps injury protections, and needleless systems) that isolate or remove the bloodborne pathogen (BBP) hazard from the workplace."
?If an alternative safety device is not available in the market to replace a precise device, one is not required to renovate those non-safety products so as to take account of safety features. Instead, it is necessary for one to constantly explore new safety device alternatives, at least annually for each device, documenting our enduring efforts to convert any non-safety sharps to include safety features.
Priority devices generally comprise sharp instruments, including sutures, blades and knives, intravenous (IV) catheters, hypodermic needles, etc. The Centers for Disease Control and Prevention (CDC) once reported in their national sharps injury report that, "Up to 86 percent of needlestick injuries can be prevented by using safety-engineered needles and other devices."
?Information has that the four most frequent sharps injuries involve blood-filled needles such as butterfly needles, phlebotomy needles, syringes and IV catheter stylets. Moreover, the injuries reported occurred 28% of the time during use and 22% of the time after use and before disposal.
?It would be worthwhile conducting trials in hospitals and clinics to test specific safety devices. Trials were placed in locations based on specific areas of expertise related to each product.?These trials could include participation of physicians and nurses where they could be asked to document evaluations for the various selected safety devices. Trials elsewhere have revealed that not all safety devices and products provide a safe option. This is a perfect time to replace those items with appropriate safety devices.
?There are bodies that require ongoing selection, evaluation, implementation and education of new safety devices as they become available. A safety device committee is required to be formed, with representation from nearly every specialty to help evaluate new safety devices, and send in monthly to these organisations.
?No doubt costs to convert to safety devices are high. Then there are costs associated with this conversion such as staff training, etc. However, this could well result in the reduction of exposure to injuries and the underlying costs therein.
The following gives an interesting insight into one such conducted study:
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?The U.S. General Accounting Office (GAO) conducted an analysis of costs surrounding the implementation of safety devices. The analysis focused on healthcare workers (HCWs) in hospital environment, representing approximately 40% of HCWs nationally. It was?estimated that nearly 400,000 percutaneous injuries occur annually in hospitals. It is estimated that almost 20% needlesticks in hospitals can be prevented in one year by using needles with safety devices. This reduction may prevent at least 25 new cases of hepatitis B virus (HBV) infection and at least 16 new cases of hepatitis C virus (HCV) infection per year. Then there was another estimate that nearly 15% needle sticks could be prevented each year by using safer work practices such as:
?No doubt needles manufactured with precision and well-designed safety features are more expensive than conventional needles. Yet the resultant benefit more than justifies this investment as the financial implications of needlestick injuries could be anywhere between 2 to 3 times the cost of introducing a new safety device in the hospital.
?It is possible that that only those hospitals experiencing high-cost scenarios for post-exposure treatment will experience benefits exceeding costs when implementing safety-engineered devices.?However, there is no price tag to show the savings for preventing just one staff member from experiencing the emotional stress of a needlestick injury, let alone the costs of a serologic test???????????conversion.
?Many hospitals known for their safe practices and safety standards recommend monitoring and documenting the following:
?The phrase `Safety First’ was definitely coined with much thought and it certainly has wide ramifications.
Dhanraj G. Chandriani
Managing Director
Technecon Healthcare Pvt. Ltd.