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Sharp Safety

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Sharp Safety

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    1. Sharp Safety Dena Cornett, R.N. & Lorrie Vandiver, R.N. Northeastern State University

    2. Problem According to the ANA the latest research indicates that “nearly two-thirds (64percent) of U.S. nurses say needle stick injuries and blood borne infections remain major concerns, and 55% believe their workplace safety climate negatively impacts their own personal safety”(ANA, 2008, p.1).

    3. Identification of Problem Health care workers (HCW) not using safety needles in all clinical areas Exposure Control Plan for the facility recognizes it is responsible for providing safety needles Nurses have the right to choose which devices they prefer

    4. Identification of Problem HCWs who sustain needle sticks must have: Immediate post exposure testing Follow up testing at: Six weeks Three months Six months Possibly one year (depending on risk) These tests can be painful and time consuming! (ANA, 2002, p. 11)

    5. Identification of Problem “Writing employee safety policies alone that merely comply with JCAHO or state regulations is insufficient for changing the overall safety culture and reducing employee safety incidents” (Hooper & Charney, 2005, p. 395).

    6. For health care workers, would the implementation of an educational program along with the addition of unit specific EBP champions, compared to the current standard of care, reinforce the importance of the use of safety needles and thus reduce the risk of exposure to blood borne pathogens and the costs inferred by needle stick injuries? PICO QUESTION

    7. Significance of Problem One strategy used for preventing sharp injuries is using safety needles Spring 2010, nurses tested three types of safety needles Nursing staff voted for the device they preferred Safety needles ordered and available

    8. Significance of Problem Barriers to the implementation of safety needle use: Inadequate horizontal/vertical communication Powerlessness Resistance to change Intimidation (Hagstrom, 2006, p. 395)

    9. Significance of Problem Barriers to the implementation of safety needle use: Inconsistencies in practice Negative attitudes Inexperience of medical staff members Time constraints (Hagstrom, 2006, p. 395)

    10. Impact of Problem Physical Injury Estimated three million HCWs experience percutaneous injury with contaminated sharp each year. These exposures result in about: 16,000 HCV infections 66,000 HBV infections 1,000 HIV infections 1,100 deaths and disabilities (Pruss-Ustun, 2005, p. 487)

    11. Impact of Problem Financial Costs The costs of an average treatment can be upwards of $3,000 per needle stick Infection by blood borne pathogen can add up to one million dollars or more (ANA, 2002, p. 12) Cost of litigation Prevention is the most cost effective strategy

    12. Impact of Problem Psychological Impact Symptoms attributed to exposure incident (Gershon et al., 2000, p. 424) Impact on Individuals family Emotional Physical Financial Impact on Nursing Community Nursing shortage

    13. Literature Review Occupational safety needs to be a priority in health care settings A study on a sharp awareness campaign reported the number of injuries reduced from 163 to 86 (Sossai, 2010, p.44) A pilot study suggests that reduction in the rate of needle sticks can be accomplished by staff education and the use of safety needles (Chow, Wong, & Suranyi, 2009, p. 124) A study of medical students found 80.9% of students exposure were the result of needle stick and sharp injuries (Askew, 2007, 9. 368)

    14. Literature Review Increased risk for contracting a BBP with each sharp injury Among nurses who sustained a needle stick injury, four sustained multiple injuries (Smith, Smyth, Leggat, & Wang, 2006, p. 72-73) A study in a North Israel hospital revealed that of 183 respondents, 120 had received needle stick injuries and that on average it happened twice (Tabak, Shiaabana, & ShaSha, 2006, p. 1234)

    15. Literature Review Availability of safety needles A study in Italy reports a high risk for percutaneous exposure to BBP in nursing student due to the lack of safety needles (Petrucci, Rosaria, Giancarlo, Cerone, & Lancia, 2009, p. 342) A study done on home health nurses’ practice revealed that safety needles were not always available for patient care (Scharf, McPhaul, Trinkoff, & Lipscomb, 2009, p. 278)

    16. Literature Review Awareness of risks to HCWs Study in Nigeria found that some HCWs had negative attitudes implementations of universal safety precautions (Amoo, McKinde, & Tijani, 2008, p. 91) EBP is critical practice for nurses who want to reduce the risk of personal injury Barriers identified: Time Knowledge (Koehn & Lehman, 2006, p. 209)

    17. Literature Review Implementation of EBP Forming proactive groups instead of post-incident reviewing could reduce risks and complaints while helping provide a safer environment for staff and patients (Hart, Huddleston, & Smith, 2006, p. 30) Nurses are the largest professional group in health care and central to implementing change in practice (Leeman, Baernholdt, & Sandelowski, 2006, p. 192) An effective way to promote change is to appoint a change leader (Leeman et al., 2006, p.197)

    18. Approaches to Problem Focus on changing attitudes and education of staff Educational program Nurses educational level (Koehn & Lehman, 2008, p. 214) In-service on safety needles by representative Safety officer implement a EBP educational program Implementation of EBP champion Horizontal communication more effective (Pravikoff, Tanner, & Pierce, 2005, p. 40) EBP champion Collaboration (Schmidt & Brown, 2009, p. 36)

    19. Leadership Support Nurse Executive Committee Approval Unit Council EBP Champion Supplies Educational Program by Safety Officer

    20. Evaluation Performance Related Decrease in Incident Reports EBP Champion reports to Unit Council

    21. Questions?

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