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Implementation of an Enhanced Safety-Engineered Sharp Device Oversight and Bloodborne Pathogen Protection Program at a Large Academic Medical Center

Published online by Cambridge University Press:  10 May 2016

Thomas R. Talbot*
Affiliation:
Department of Medicine, Division of Infectious Diseases, and Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee
Deede Wang
Affiliation:
Department of Quality, Safety, and Risk Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Melanie Swift
Affiliation:
Department of Medicine, Division of General Internal Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Paul St. Jacques
Affiliation:
Department of Anesthesiology and Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee
Susan Johnson
Affiliation:
Environmental Health and Safety, Vanderbilt University Medical Center, Nashville, Tennessee
Vicki Brinsko
Affiliation:
Department of Quality, Safety, and Risk Prevention, Vanderbilt University School of Medicine, Nashville, Tennessee
Valerie Thayer
Affiliation:
Occupational Health Clinic, Vanderbilt University Medical Center, Nashville, Tennessee
Teresa Dail
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Nancye Feistritzer
Affiliation:
Hospital Administration, Vanderbilt University Medical Center, Nashville, Tennessee
Shea Polancich
Affiliation:
Department of Community Health, Outcomes, and Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
*
A2200 Medical Center North, 1161 21st Avenute South, Nashville, TN 37232 ([email protected]).

Abstract

Objective.

Exposure of healthcare personnel to bloodborne pathogens (BBPs) can be prevented in part by using safety-engineered sharp devices (SESDs) and other safe practices, such as double gloving. In some instances, however, safer devices and practices cannot be utilized because of procedural factors or the lack of a manufactured safety device for the specific clinical use. In these situations, a standardized system to examine requests for waiver from expected practices is necessary

Design.

Before-after program analysis.

Setting.

Large academic medical center.

Interventions.

Vanderbilt University Medical Center developed a formalized system for an improved waiver process, including an online submission and tracking site, and standards surrounding implementation of core safe practices. The program’s impact on sharp device injuries and utilization of double gloving and blunt sutures was examined.

Results.

Following implementation of the enhanced program, there was an increase in the amount of undergloves and blunt sutures purchased for surgical procedures, suggesting larger utilization of these practices. The rate of sharp device injuries of all at-risk employees decreased from 2.32% to 2.12%, but this decline was not statistically significant (P = .14). The proportion of reported injuries that were deemed preventable significantly decreased from 72.7% (386/531) before implementation to 63.9% (334/523; P = .002) after implementation of the enhanced program.

Conclusions.

An enhanced BBP protection program was successful at providing guidance to increase safe practices and at improving the management of SESD waiver requests and was associated with a reduction in preventable sharp device injuries.

Type
Original Article
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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