Michael BoyerEpidemiologyOctober 27, 2014Review of Needle Stick and Sharps Injuries at the MEE of Boston

Introduction:

Hospitals are traditionally thought of as a place of healing, where the sick come to get better and the weak regain their strength. For most of us this is true, but for those working in these facilities the hospital can become a dangerous environment. Most doctors, nurses and anyone who helps on a medical team work long and grueling hours, potentially overnight and through breaks in time of urgent care. They are constantly exposed to those who are sick and to many that do not wish to be there. These high paying jobs come with large amounts of stress. Like with any job, work injures do occur, however these injuries can be a matter of life or death. One of the most common injuries to hospital workers involved in procedures are needle stick and sharps injuries (OSHA). These injuries occur when a needle or sharp tool punctures the skin. Infectious diseases, including all blood borne pathogens, can be transmitted from this injury (OSHA). In many cases the injury is more painful than life threating, but there is the rare occurrence of being exposed to dangers like HIV or Ebola. Injuries during a procedure can comprise its end result, potentially costing a patient their life. By examining and analyzing data collected from the staff at the Massachusetts Eye and Ear Infirmary in Boston, I hope to better understand and help prevent sharps and needle stick injuries. I will be investigating which tools cause the most injuries, what type of procedures these injuries occur during and type of medical attention that had to be sought by the injured employee. Data could be split and viewed specifically for sharps or needle stick injuries only. I will also attempt to pinpoint when the injuries occur; during/after disposal, after use before disposal, or during use to see whether it is the tool itself that is danger or if it could be the motion or use of the tool. Our main goal will be to see which devices are more or less risky and whether there is a safer alternative. If there is not a safer alternative, more training may be suggested or the implementation of a new policy which attempts to alleviate the stress during procedures.

Annually, an estimated 384,000 sharps or needle stick injuries involving healthcare personnel occur (NORA). These estimates are considered to be very low since the collection of this information can often be forgotten about or not even reported. Many doctors may not report a minor injury since they may lose time at work, but in reality they may have contracted a deadly blood borne pathogens. Although there is a vaccine for the blood borne pathogen Hepatitis B Virus, there remains none for HIV or the Hepatitis C Virus (NORA). Hospitals often underreport these types of injuries because they can be costly when trying to get accreditation or when reporting injuries for insurance purposes. CDC sponsored meetings have realized that a sound strategy involving improved surveillance, extended education and training, and an increase use of tools with sharps injury prevention mechanisms will help decrease the number of injuries to healthcare personnel (NORA).

Broad Goal:

The broad goal of this research is to help create a safer working environment for hospital workers, thus in return creating a more efficient environment for the patient.

Research Question:

What devices are contributing to the most sharps injures at the Massachusetts Eye and Ear Infirmary in Boston and what can be done to prevent them?

Objectives:

1.) To create denominators to asses which procedures have the highest number of injuries, highest injury rate, which motion has the most number of injuries, and which motion has the highest injury rate.

2.) To evaluate which tool is the most dangerous and see if a safer alternative is available. 3.) To develop and implement new, safer strategies when handling potentially dangerous tools.4.) To maintain a database for future studies and reference.5.) Compare data with that collected by the Massachusetts Department of Public Health.

Methods:

The data set that is going to be reviewed has been collected by the Employee Health and Infection Control Departments at the Massachusetts Eye and Ear Infirmary in Boston. Once I receive the data, I may be able to work on it from any desired location; if not my work cite would be located in the Infection Control Department at the MEEI.

The population for my study will be any employee inured from a sharp or needle stick while working at the Massachusetts Eye and Ear Infirmary during the time data was collected. The injury, rather than injured will be examined. The only medical history that will be needed will be to examine what type of follow-up treatment occurred after the injury.

1.) Any rate or count of injuries will be evaluated using statistical analyses of the dataset. Denominators will be created based on which variables are available from the data set. SPSS will be used to run all analyses.

2.) Statistical analysis will help show which tool is the most dangerous, similar to the first objective. To see if a safer alternative is available, a review of current tool models and safety features will be completed.

3.) To develop and implement safer strategies, old guidelines must be reviewed and updated to help protect today’s worker

4.) One central database will be created and backed-up to ensure that future studies can reference it.

5.) Data will then be compared with information collected by the Massachusetts Department of Public Health

References:

United States Of America. U.S. Department of Labor. Occupational Safety & Health Administration. Healthcare Wide Hazards: Needlestick/Sharps Injuries. N.p., n.d. Web. 19 Oct. 2014. https://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html

United States of America. NORA. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Identification of Research Opportunities for the Next Decade of NORA. N.p.: n.p., n.d. CDC. CDC & NIOSH, Aug. 2009. Web. 05 Dec. 2014. <http://www.cdc.gov/niosh/docs/2009-139/pdfs/2009-139.pdf>.