Safe Practices: Preventing Needlestick Injuries

Dr Mary Foley

I recently had the privilege to learn more about the Safe in Common campaign, an exciting healthcare initiative that is promoting safe work environments free from needlestick injuries from one of the leading health worker safety advocates, Dr. Mary Foley. Below is our interview. Please read and consider taking the pledge for preventing needlestick injuries and creating safe work environments.

(Kelly) What has been your experience with the general "culture" or perception by nurses and other healthcare professionals regarding needlestick safety?

(Dr Foley) In my experience, healthcare workers are focused on patient care.  They are aware of needlestick risks, but they keep their worries about occupational injury in the background, so they can focus on giving the best care they can.  That presents some danger to healthcare workers.  Doctors, nurses, aids, lab technicians, housekeeping, and maintenance personnel are all at risk when sharps devices and delivery systems are not designed for maximum protection.

(Kelly) Can you estimate the cost in lost wages or medical care annually related to needlestick injuries?  What is the emotional cost?

(Dr Foley) There is an emotional cost to the ever-present threat of an injury, which is there even if a healthcare worker manages to keep the concerns "controlled", so they can focus on patient care. 

When a worker is exposed to a contaminated device, there is an immediate sense of panic, since this could be an infected device.  In spite of that fear, or maybe because of it, almost half of all injured workers fail to report their injury—which puts them at risk for no coverage if they become ill.

Injured workers talk about the tension in their personal and family lives as they wait for test results which are conducted over 6 or more months to determine if the worker is infected.  Some healthcare personnel are encouraged to take prophylactic medications, some of which are difficult to tolerate.  

The preferred future: reduce accidental injuries with better devices, proper training, and a culture of safety.

(Kelly) Can individual nurses make a difference?

(Dr Foley) Individuals can make a difference. Care for the caregivers begins with self care—being as knowledgeable as possible about protecting patients and oneself.  But many of the improvements in health care settings will require collective action by policy makers, device makers, occupational health specialists, managers, and staff.

(Kelly) What can we all do to offer our support?

(Dr Foley) The Safe in Common campaign was launched in May, and we already have thousands of pledges of support.  Just as importantly, the subject of sharp injury prevention is active again, over 10 years after the passage of the Needlestick Safety and Prevention Act.  There have been some improvements in some rates of injuries, but there are still too many occupational injuries from sharps, and now, many of those occur when staff uses "safety" devices. Clearly, the devices in use are not adequately protecting staff, and more work must be done.

Spread the word (thank you for writing about this), share the pledge, advocate for educational content and conference programming that informs and advocates for better protection.

(Kelly) Can you provide any statistics / facts about the frequency and gravity of needlestick injuries?

(Dr Foley) Virtually all healthcare personnel are at risk of harm from occupational exposures such as needlestick injuries. The Center for Disease Control notes that nurses sustain approximately half of all needlestick injuries, while physicians, housekeeping and maintenance staff, technicians, and administrators are also harmed.

The U.S. Occupational Safety and Health Administration (OSHA) estimates 5.6 million workers in the U.S. healthcare industry are at risk of occupational exposure to bloodborne pathogens via needlestick injuries and other sharps-related injuries. OSHA further reports that each year 385,000 needlestick injuries and other sharps-related injuries are sustained by hospital-based healthcare personnel. This equates to an average of around 1,000 sharps injuries per day in U.S. hospitals.

Including other non-acute healthcare facilities, it is estimated that between 600,000-800,000 healthcare personnel incur a needlestick injury each year in the U.S.

Forty percent of injuries occur after use and before disposal of sharp devices, 41% of injuries occur during the use of sharp devices on patients, and 15% of injuries occur during or after disposal.

(Kelly) How did you get involved advocating for needlestick safety?

(Dr Foley) As a registered nurse for more than 35 years, I was one of the first healthcare workers to combat the emerging HIV-AIDS epidemic during my work at Saint Francis Memorial Hospital in San Francisco during the 1980s. I played a key role in securing the passage in California of the first state-based laws in the U.S. mandating the use of safety medical devices. Afterwards, I joined other nursing colleagues to campaign for the adoption of the Federal Needlestick Safety and Prevention Act. Elected President of the American Nursing Association (ANA) in 2000, I was in the Oval Office of the White House when President Bill Clinton enacted the Act into law. Since, I have continued to work to improve healthcare policy, including improving the workplace, and promoting safe care for workers and patients nationally and internationally. Given my passion and knowledge of the issues, Safe In Common asked me to lead their Needlestick Safety Advocacy Tour.

(Kelly) What does Safe in Common do to protect healthcare personnel?

(Dr Foley) Safe in Common is a movement of healthcare personnel committed to making their working environment safe from the risk of needlestick injury. With the safest equipment, the best practices and the right culture, we believe all needlestick injuries can be prevented. The non-profit organization was established to enhance and save the lives of U.S. healthcare personnel at risk of harm from needlestick injuries.  First established in 2010 as an online community of healthcare professionals and other advocates committed to injection safety, Safe in Common is leading the Needlestick Safety Advocacy Tour across the U.S from March 2012 through March 2013 to engage with healthcare personnel to hear their concerns, raise their hopes and unite them together behind the creation of a workplace environment that is free from the risk of needlestick injury. 

The Tour will visit more U.S. hospitals and attend healthcare conferences across the nation during the first stage of the national campaign. At each location, Safe in Common representatives will advocate for needlestick safety, record real stories from healthcare personnel, and provide demonstrations of the latest safety-engineered medical devices that can help to deliver optimal protection to those at risk of harm.

(Kelly) What is the Safe in Common Pledge?

(Dr Foley) The pledge is the cornerstone of the NSAT: http://www.safeincommon.org/needlestick-safety-pledge.

Our goal is to have at least 100,000 healthcare personnel take the pledge as a show of support that more can be done to reduce needlestick injuries. The pledge, which can be taken online or in person wherever SIC is engaging healthcare personnel, says “A safe working environment is essential if I am to effectively serve the needs of my patients. Needlestick and sharps injuries represent one of the most serious threats to occupational safety within my facility.”

The pain and trauma that these injuries inflict upon healthcare personnel, and their loved ones, is unacceptable. The dollars lost each year in the testing and treatment of reported injuries is unacceptable. The continued use of medical equipment that fails to adequately address the safety and functional needs of healthcare workers and their patients is unacceptable.

Thank you Dr Foley for sharing this important topic with my readers. Patient safety causes often take priority over safety initiatives for ourselves. As nurses, other healthcare providers and ancillary services it is imperative to use caution and advocate for safe and healthy work environments.


Please follow the link and take the Safe in Common Pledge!