Creating a Positive Culture of Safety

around Sharps Injury Prevention

Culture of Safety:

The product of individual and group:

ValuesAttitudesPerceptionsCompetencies and Patterns of behavior

that determine commitment to and the styleand proficiency of an organization’s health andsafety management.(Reference: Sorra et al, AHRQ Pub No. 04-0041)

Safety Culture:

• The shared values within an organization with regard to safety.

• Expressed in the willingness to evaluate and learn from adverse events

(References: Griffin & Neal, Journal of Occupational Health Psychology, 2000

Zhang, et al. Proceedings of the 46th Annual Meeting of the Human Factors and Ergonomics Society, 2002)

Safety Climate:

• The shared perception, at a point in time, of the safety culture within an organization.

• The degree to which employees feel that safety is an organizational value.

(References: Griffin & Neal, Journal of Occupational Health Psychology, 2000

Zhang, et al. Proceedings of the 46th Annual Meeting of the Human Factors and Ergonomics Society, 2002)

• Organizational commitment– Demonstrated at the highest levels in the

organization

• Management involvement– Commitment of resources

• Employee empowerment– Freedom to voice concerns about hazards

Components of a Positive Culture of Safety:

Components of a Positive Culture of Safety:

• Systems to acknowledge safe practices

• Reporting systems– Injuries– Safe behaviors– Near misses– Hazards

Who’s involved? What’s their role?

Management

• Acknowledge positive behaviors• Allocate resources for new safety products and

processes• Ensure that all staff are aware of and receive training

when changes are made• Address suggestions made by staff to improve safety

Staff

• Acknowledge co-workers’ positive behaviors • Provide feedback to management on safety activities

and new devices• Participate in training• Voice concerns about hazards to management• Offer solutions to identified hazards

Who’s involved? What’s their role?

Safety Culture and Sharps Injuries

Nurses with a positive measure of safety culture more likely to accept newly introduced IV catheter safety device

Safety Culture and Sharps Injuries

Measures of safety culture are associated with compliance with safe work practices

Employees with higher measures of safety culture were half as likely to experience blood/body fluid exposure incidents

Activities specific to Sharps Injury Prevention

• Engineering Controls– List of conventional devices identifying where

they are used– Inventory of devices with safety features– Rigid sharps disposal containers

• Training on the use of devices with safety features

Activities specific to sharps injury prevention (continued)

• Sharps Injury Prevention Committee– Analysis and use of data in decision making

• Process for identifying and reporting hazards

• Process for reporting exposure incidents– Well developed post-exposure management protocols

• Bloodborne pathogen training– Upon hire and annually– Review of hazards, prevention measures and

reporting protocols

• Educational campaigns– In-services– Posters

Activities specific to sharps injury prevention (continued)

Sharps Injury in the OR

Safety Culture Factors

• Long shifts

• Use of sharp suture needle

• Use of long length of suture material

• Unable to leave operating room

• Waiting until the end of the shift to report the exposure

Changes

• Shorter shifts to avoid fatigue

• Use of blunt suture needles

• Shorter suture material

• Identify someone in OR to call Occupational Health for exposures

• Triage exposure over the phone

• If necessary, Employee Health brings PEP to OR

Impact of positive changes:

• Reduction of hazards with suture needles→ reduction / elimination of injuries involving suture

needles

• Improved reporting• More timely post-exposure management• Improved employee safety and patient care

…the shared commitment of management and employees to ensure the safety of all care providers and patients in the facility.

Together we can make it work!

Culture of safety….