UPDATE HEALTH & SAFETY
Member states, the UK included, have until 11 May of this year to ensure the provisions of the directive have been implanted into national legislation. In time for this deadline, the Health & Safety Executive (HSE) is rolling out new regulations, provisionally called the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, that require the healthcare sector to introduce arrangements for the safe use and disposal of medical sharps; to provide information and training to employees; and to record, investigate and take action following a sharps injury. Healthcare employers already have a legal duty under the Control of Substances Hazardous to Health Regulations 2002 and The Management of Health and Safety at Work Regulations 1999 to carry out a suitable and sufficient assessment of sharps risk. CCGs have a role to play in the procurement of safer products and services in their localities, as well as providing group-wide information on the subject.
There is no reliable data on the number of sharps injuries to healthcare workers, but studies estimate that there may be as many as 100,000 every year in the UK. A Care Quality Commission survey of NHS staff found that two per cent had reported a needle-stick injury in the 12 months.
SELECTING SAFER SHARPS One of the principles of the directive is based on the idea of employers and staff working together at the appropriate level to eliminate and prevent risk. This includes procuring and commissioning safer equipment, carrying out training and raising awareness. In recent years, alternative medical equipment has been made available that incorporates a protection mechanism, like a device to cover the needle. Companies like PDD work to design out risk in the products they produce. They believe it is important that any engineered solution must be an integral part of the safety device – not a separate accessory and easy to use. “There are all sorts of solutions that are trying to passively – meaning you don’t have to do anything, they do it automatically – make
the devices safe, but you can’t be 100% on all of those,” says PDD’s director of medical Alun Wilcox. “What it comes down to is attitudes and training.”
t“You don’t want to give hem something which
means they have to change all the things that they’ve developed in terms of safe handling techniques that could in effect make it more dangerous because it’s unfamiliar to them and they might just slip up”
Cost is also a factor to consider. “These needle-safe devices incorporate all sorts of different springs and retraction mechanisms, which necessarily cost more,” adds Wilcox. “From a healthcare provider’s point of view, what is the cost-to-risk benefit of supplying these devices? That will be interesting.” He continues: “It’s only if they make them in high enough volumes that they can value-engineer them to the maximum, but they are always going to be more expensive.” Ensuring it’s intuitive is important too – you don’t want to throw the baby out with the sluice water and put patients at more risk because of untrained staff. “You don’t want to give them something which means they have to change all the things that they’ve developed in terms of safe handling techniques that could in effect make it more dangerous because it’s unfamiliar to them and they might just slip up,” Wilcox explains. As a result, some healthcare employers are also seeking ways to reduce the need to use sharps in the first place by opting for procedures that do not require it.
CAUSE AND EFFECT But what is it that contributes to sharps injuries to begin with? Recapping of needles by hand after use is a well- recognised cause in the healthcare sector – hence the ubiquitous yellow sharps disposal boxes. The directive seeks to ban recapping altogether and the HSE’s
regulations outline that it should be eradicated except where absolutely necessary to control a risk of airborne infection. Furthermore, as more care occurs in the home, where needle-sticks can also frequently occur, commissioners should be thinking about how they ensure that environment is safe too.
END RESULT
While the proposed HSE regulations will only apply to employers, contractors and workers in the healthcare sector, CCGs and organisations tasked with the management, organisation and provision of healthcare will be subject to the regulations. The proposed regulations build on existing regulations and in summary, require healthcare leaders to identify a number of risk control measures to take; provide detail on what information and training is needed for workers; set out action to be taken to reduce sharp injuries. While this is not the responsibility of the commissioner, rather the provider, it’s still important commissioners are aware and take on a needle-stick safe mentality. After all, the symptoms of the dreaded PEP are nothing when compared to what could happen as the result of a tiny needle poke.
FURTHER RESOURCES
For more information on the HSE’s consultation, see
www.hse.gov.uk/ consult/condocs/cd244-analysis. pdf and
consultations.hse.gov.uk/ gf2.ti/f/16834/445093.1/PDF/-/ CD244%20final.pdf
For details on needle-stick sharps injury prevention in general, see
www.nursingworld. org/mainmenucategories/ anamarketplace/anaperiodicals/ ojin/tableofcontents/volume92004/ no3sept04/
injuryprevention.html and
www.rcn.org.uk/__data/assets/ pdf_file/0008/418490/004135.pdf
www.saferneedles.org.uk/
www.europeanbiosafetynetwork.eu/
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