From the Massachusetts Nurse Newsletter
October 2008 Edition
By team members of Project SHARRP at UMass Lowell & the Massachusetts Department of Public Health.
The September edition of the Massachusetts Nurse featured the key results of the Project SHARRP survey that was conducted by researchers from UMass Lowell in collaboration with the Massachusetts Department of Public Health (“Safety and health among Massachusetts home care nurses: bloodborne pathogen exposures”). The SHARRP survey provided insight into the use of sharps devices with integral safety features among home healthcare nurses. These “safety” devices are thought to be key elements for sharps injury prevention. Furthermore, OSHA’s Bloodborne Pathogen Standard requires the evaluation and use of sharps with safety features in all workplaces.
When asked about the use of sharps’ devices with and without safety features, 89 percent of home healthcare nurses reported that their employers supplied at least some sharps with safety features, and most nurses were currently using such devices. In some cases, nurses were using a sharps device with a safety feature for which they had not received training (30 percent). Even though sharps with safety features are widely available, 39 percent of nurses reported that they still use sharps without safety features.
The principal procedures involving the use of sharps lacking safety features included: medication injection, venipuncture and fingerstick/ heelsticks. Sometimes, nurses did not use the safety device provided. When asked why, the main reasons given were: it is “more difficult to use than a standard device” (26 percent), the “safety feature does not work well” (24 percent) and it “takes more time to perform the procedure than with a standard device” (7 percent).
The survey data allowed us to better understand nurses’ perspective on the use and effectiveness of sharps with safety features during the period following the adoption of the Needlestick Safety and Prevention Act (2000), which required revision of OSHA’s Bloodborne Pathogen Standard and mandated the careful evaluation and routine use of medical devices with safety features. In our data for sharps injuries for the period 2001-20071:
- 65 percent of the sharps injuries involved a sharp device without a safety feature. Of these cases, 66 percent of nurses believed a safety feature might have prevented the injury (see chart above, right).
- 28 percent of the sharps injuries involved devices having a safety feature, however, the nurse reported that the safety feature failed.
The Project SHARRP survey results demonstrate a need for preventive interventions against sharps injuries and other blood exposures among home healthcare clinicians. It is important to note that despite these bloodborne pathogen exposures, the vast majority of home healthcare nurses who took the SHARRP survey reported being satisfied in their jobs (94 percent either “satisfied” or “somewhat satisfied”). Interventions for injury and exposure prevention in home healthcare (e.g. sharps device design, public and agency policies, workplace practices) need to be implemented to eliminate or minimize job hazards without decreasing job satisfaction. The input of frontline home healthcare clinicians, including MNA members, will be invaluable for the development of prevention measures and communication methods.
Project SHARRP thanks everyone who supported this research. Home healthcare nurses who are interested participating in future studies, or any other questions/comments, please contact Project SHARRP at 978.934.3386 or sharrp@uml.edu. The mailing address is: Project SHARRP Research Team, Kitson 200, UMass Lowell, One University Avenue, Lowell, MA 01854. Device with safety feature 31% Don’t know or missing 4% Device without safety feature 55% Sharps injuries: Did the medical device have an integral safety feature? Data from Massachusetts home healthcare nurses, 2001-2007; most recent sharps injury reported {n=124] Use of sharps’ devices with and without safety features: Massachusetts home healthcare nurses
1These data do not include all SIs during 2001- 2007, only the most recent SI reported by each respondent.
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