HEALTH & SAF E T Y
Reducing needle stick injuries in healthcare
In the five years to 2017, NHS Resolution paid over £4 million in compensation to 1,213 claimants for needle stick-related injury. Chris Stanton provides an insight into strategies for reducing the risks to patients and healthcare workers, using engineering analysis tools.
Obligations are placed on healthcare providers to ensure staff safety is maximised by reducing the risks present in the workplace. This duty of care extends beyond employees to cover everyone who may be injured by activities undertaken in the routine processes and standard operating procedures of a hospital, clinic or other medical centre. Injuries are preventable. They lead to physical and psychological trauma, are expensive and a burden on healthcare resources, as well as causing significant reputational damage to the hospital.
Many injury prevention methods rely on working practices, staff training and competence, yet safety can be addressed more effectively by equipment design, which eliminates or dramatically reduces injury risks. The benefit of an equipment design solution is that the risk can be eliminated by reducing the danger at point-of-use or point- of-action, or otherwise referred to as a ‘no fault forward’ methodology. This is important as implemented procedures often adequately address risk in one area, only for it to cause an increased risk downstream. An injury can be considered a ‘process failure’ and so, with careful consideration of risk management, it can be mitigated to a safe level or, ideally, eliminated completely. These risks need to be addressed not only in the direct hospital environment, but beyond. It is injuries that occur outside of the hospital
Industrial analysis techniques Cost sensitive industrial sectors, such as aerospace and automotive, are on a constant mission to improve reliability. Any defect or failure in a process adds cost and increases risks which reduces reliability. So, they thoroughly manage the entire end-to-end process – from design concepts, through to manufacturing, distribution, during use by their customer, disposal and end of life. Only when the entire process is managed and optimised can they be sure they can reduce those process failures and achieve optimum reliability.
that are often overlooked, yet healthcare providers are responsible for the complete end-to-end process. It is important that any risk analysis takes into account the potential process failures that can occur away from the controlled environment of the hospital. Optimised equipment design facilitates ‘no fault forward’ and is a technique used widely in industry, so what other methods could be adopted to help the healthcare sector reduce injury rates?
An injury can be considered a ‘process failure’ and so with careful consideration of risk management, it can be mitigated to a safe level or ideally, eliminated completely. These risks need to be addressed not only in the direct hospital environment, but beyond.
MARCH 2021
The methodology often used is called Failure Mode Effect Analysis (FMEA) and is a tool to manage risks by identifying potential failure modes and addressing them. This is important as it is the failure modes which enable the identification of risk. Once the risk has been identified, it can be objectively assessed and corrective actions can be instigated. One of the key benefits of this approach is that it can eliminate the risks of injury by preventing them from occurring in the first place. This is a result of a greater focus of design and less reliance on human skills, competence and training. Let us consider the topic of needle stick injuries in healthcare. In the five years to 2017, NHS Resolution paid over £4 million in compensation to 1,213 claimants; 88% of the claimants were ancillary staff or staff from other non-clinical occupations. This shows that design has not been as effective as it could have been and process failures were not sufficient to eliminate risk or reduce to a safe level. The risk might have been well managed for the clinical setting, but the risk is not eliminated and reappears alarmingly further downstream. This demonstrates that the current process safeguards do not support ‘no fault forward’. Using tools like FMEA could help duty of care obligations. Let’s consider how it could help healthcare.
WWW.CLINICALSERVICESJOURNAL.COM l 49
▲
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88
