No healthcare worker is immune to the dangers of handling sharp objects. Doctors have a slightly lower rate than nurses, mostly related to the use of scalpels, but are less likely to report these injuries.

The occupational risk of sharps injuries in healthcare is best viewed from a global health perspective. Although often preventable, sharps injuries occur in high-income countries at an alarming rate, and low- and middle-income countries (LMICs) with higher endemic rates of blood-borne pathogens and / or limited resources present an increased risk for this. occupational hazard. In response to this often overlooked or underreported problem, the International Sharps Injury Prevention Society (ISIPS) has designated December as International Sharps Injury Prevention Awareness Month.

World Health Organization (WHO) highlights importance of this global perspective on occupational risk by offering datasets that reveal 1.5 million new cases of HIV, hepatitis B and hepatitis C from 2019 to 2020. Coupled with these data, the WHO datasets also identified a disruption in health care services for the prevention, detection and treatment of HIV and hepatitis as part of the Covid-19 pandemic.

Although HIV rates have slowly declined in the United States over the past decade, rates have increased in LMICs. This offers an acute demonstration of the disparities in access to health care and resources.

Global politics exacerbate the problem of inequalities in health care and the occupational risk of sharps injuries. Mass migration and civil unrest hamper access to health care as well as specific current trends in communicable diseases. HIV and hepatitis can easily escape detection in this population, and receiving countries may find it difficult to have sharps security products available for vaccination at border posts.

ISIPS website has a full list of sharp security products available products and manufacturers. Unfortunately, health care disparities can prevent the use of identified safety products. However, not all products are created equal. Data from the International Safety Center EPINet shows that 30.2% of the 975 sharps injuries occurred with the use of a sharps safety device. The safety mechanism has been correctly activated in approximately 10% of 290 cases.

This same report identifies that needle stick injuries (INS) with use of disposable syringes account for 27% of sharps injuries, and that nurses face the highest occupational risk in this category. Additional data in this report identifies intramuscular and subcutaneous injections as the primary source of INS. The dataset predates the COVID-19 pandemic, which potentiated an increased risk of SIDS with mass vaccination in unfamiliar and non-traditional settings, such as tents or large arenas.

Future considerations regarding safe injection practices for mass vaccination during a pandemic could include soluble microneedle skin patches. A vaccine delivery method like this can improve vaccination rates among needle-phobic clients. In addition, immunization efforts could be strengthened in LMICs with fewer resources needed for large volumes. transport and storage.

No healthcare worker is immune to the dangers of handling sharp objects. Doctors have a slightly lower rate than nurses, mostly related to the use of scalpels, but are less likely to report these injuries.

Environmental factors, such as lighting and noise, predispose the health care provider to these injuries. Even non-direct patient care workers, such as environmental or food service personnel, can be at risk when a direct care provider does not properly dispose of used sharps.

Exposure control

In the United States, the Needlestick Safety and Prevention Act was born out of the Safe Needles Save Lives campaign, launched by the American Nurses Association, and was enacted in November 2020. This law required that the Occupational Safety and Health Administration (OSHA ) revises the OSHA Bloodborne Pathogens Standard to include sharp devices designed for safety. Their vision also included the requirement that hospitals develop a bloodborne pathogen exposure control plan with annual updates and the requirement for a sharps injury log to track and trace the results. trends to identify contributing factors. This standard proposes a global prevention model to also include the use of personal and work protective equipment. practice checks.

The Centers for Disease Control and Prevention is contributing to a global sharps injury prevention model with a comprehensive manual to guide the design, implementation, and evaluation of a sharps injury prevention program. Federal and state regulatory guidelines are presented as well as the cost of sharps injuries. The user of the workbook is offered operational guidance to include a multidisciplinary approach to selecting safety designed needles and other sharp devices. Integrated toolkits guide the user through the stages of operations, with the aim of establishing a culture of safety. Data analysis to evaluate acute injury prevention interventions is presented in a methodical fashion, providing simple learnings, even to novice learner.

Sharp object safety is not confined to healthcare facilities or healthcare workers alone. Community members may need lancets or needles and syringes to monitor and treat diabetes or other medical problems. Municipal employees responsible for waste management and / or recycling can also be exposed to sharp injuries. Children and other members of the community can be injured by sharp objects if devices are not properly disposed of.

It is essential that patients receiving home care are informed of the proper disposal of lancets and needles in sharps containers approved by the Food and Drug Administration and that community regulations are followed for container disposal at home. filling level. Other countries may have similar designated sharps containers, as determined by regulatory authorities. In countries or communities with limited resources, external supports are needed to safely manage sharps. Countries that align with WHO can serve as external resources.

International Sharps Injury Prevention Awareness Month in December coincides with the end of the calendar year and, for many healthcare and political organizations, marks the end of a fiscal year. This is an opportune time to assess local, national and international resources and engage healthcare and policy makers in sharps injury prevention measures for the coming year. Raising awareness of the importance of equity in healthcare globally is of paramount importance in reducing sharps injuries.

JENNY HAYES, MSN, IA, CIC, CAIP, CASSPT, has 15 years of experience in infection prevention, serving inpatient and outpatient populations in multidisciplinary settings. She is an infection prevention specialist at the University of Pennsylvania Hospital.

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