ners for the use of safety-engineered devices and proper disposal of sharps. As COVID- 19 vaccination efforts took many healthcare practitioners outside of hospital or retail pharmacy settings, BD has generated new education materials on the proper use and disposal of its devices.”
Calabrese envisions growing opportuni- ties for improvements in these incidences in care settings.
“In my opinion, awareness and dedica- tion to sharps safety is lacking throughout institutions,” she expressed. “Now, in 2021 we require a new impetus on safety. eadership has to fill in the gaps, engage clinicians, manufacturers, and professional and accrediting associations to not only advocate for safety but to inspire HCWs to foster a culture of safety throughout healthcare facilities. There are a litany of best practices, products and technology available, however, HCWs must be com- pelled to actually use them.”
Ramping up disposal
How have clinical, infection prevention or safety leaders handled sharps safety in their facilities? A drive toward getting more shots in arms in communities means an increased need for disposal of sharps supplies. “A shortage in the supply of Food and
Drug Administration (FDA)-cleared sharps disposal containers may occur during the COVID-19 mass vaccination campaign or as a result of other causes. Healthcare facilities and COVID-19 vaccination sites must use sharps disposal containers that meet Occu- pational Safety and Health Administration (OSHA) Bloodborne Pathogens standard requirements to dispose of contaminated needles and other sharps,”2
stated the Cen-
ters for Disease Control and Prevention in its guidance.
The agency added, “Conserve your FDA-cleared sharps disposal containers to help avoid a potential supply shortage. If FDA-cleared sharps disposal containers are unavailable, then consider using alternative containers that meet the OSHA require- ments after checking your states specific disposal requirements at SafeNeedleDis-
posal.org and discussing disposal options with your medical waste vendors.” 2 The FDA explained it “has evaluated the safety and effectiveness of these containers and has cleared them for use by health care professionals and the public to help reduce the risk of injury and infections from sharps. FDA-cleared sharps disposal containers are made from rigid plastic and come marked with a line that indicates when the container should be considered full, which means it’s time to dispose of the container.”3
With regard to alternative sharps disposal containers, the FDA stated, “If an FDA- cleared container is not available, some organizations and community guidelines recommend using a heavy-duty plastic household container. The container should be leak-resistant, remain upright during use and have a tight fitting, puncture-resistant lid, such as a plastic laundry detergent container.”3
Raising bar on safety
What are the best practices for preventing sharps injuries, pathogen contamination and transmission and infections in care? LaJoie states that “BD recommends the following to help ensure the safety of healthcare practitioners following delivery of a skin injection: • Activate the safety mechanism immedi- ately following the administration injec- tion
• Keep handling to a minimum • Discard sharps at point of use into an approved sharps container
• Ensure approved sharps containers are located in a safe position
• Seal sharps containers as soon as the contents reach the indicated fill line and dispose of them according to local policy
• Report needle stick injuries • Adhere to local policy and procedure, as well as health and safety requirements
• Follow correct use and application of safe medical devices.”
Calabrese highlights clinical practices to help decrease the potential for incidences of surgical site infections (SSIs). “Going back to COVID, our world revolves around bacteria and viruses,” she stressed. “To combat bacteria, we admin- ister antimicrobial prophylaxis prior to the surgical incision. The risk from a virus, for example, Hep B or C, can be transferred from a needlestick or suture needle pen- etrating a glove(s).”
She continued, “OR staff can reduce the
risk of exposure by 87% when double glov- ing is used. In another study, the volume of blood on a solid suture needle is reduced by 95% when the needle passes through two gloves/glove layers, reducing the viral load in the event of a pathogenic contamination. National AORN, AST and ACS all agree, the best practice to protect you and your patient is to double glove with a comple- mentary underglove.”
Additionally, Calabrese shares, “Occu- pational health and safety professionals utilize a system of prevention measures known as the Hierarchy of Controls. This hierarchy is a new element to address the importance of complete safety, first and foremost to eliminate the hazard whenever
possible…if this is not feasible, implement work practice engineers.
OPERATING ROOM The umbrella of controls includes:
• Correctly wear PPE. • Choose the right gauge and length of a needle and evaluate suture needles and alternative methods of skin closure devices where appropriate.
• Increase the use of scalpels with retracting blades/handles and implement no hands passing and neutral zones to protect the surgical team members.
• Utilize correct blood and specimen tech- niques and increase compliance with disposal of these devices.
If HCWs eliminate the risk of pathogen contamination to the best of their ability, this will transcend to their patients.” Further, she notes, “The Joint Commis- sion and OSHA advocate for an Exposure Control Plan beginning with the use of uni- versal/standard precautions. OSHA also champions this plan as a living document.” As COVID-19 vaccinations are on the rise, those administering the shots also should take precautions for sharps safety and infection control. “Needlesticks and the potential exposure to bloodborne pathogens pose a risk during COVID–19 vaccinations in both traditional healthcare settings and pop-up vaccination sites. Vaccinators should follow OSHA’s bloodborne pathogens standard [OSHA 1992] to prevent needlestick/sharps inju- ries,”4
advise medical specialists on the National Institute for Occupational Safety and Health Blog.
The specialists continue, “At a minimum, ensure that all vaccinators receive training in the following: • Bloodborne Pathogens Standard (29 CFR 190.1030)
• PPE • Sharps disposal Definition of needlestick inury • Injury reporting • Sharps injury log.” BD’s LaJoie highlights “two driving
factors ensuring safe administration of COVID-19 vaccinations with patients – clinical expertise and the use of safety- engineered devices.
As part of our vaccination response efforts, BD provided resources to help ensure healthcare communities globally have the right training tools and support on injection techniques to implement their campaigns,” she continued. “ This train- ing and education is critical to help ensure that the various devices provided are used properly in vaccine administration, espe- cially as we saw many former and retired healthcare workers returning to the field to help. Additionally, using safety needles
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hpnonline.com • HEALTHCARE PURCHASING NEWS • July 2021 15
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