Recognizing the Need for Sharps Safety in Surgery

February 21, 2017

By: Adeline Yi, Anzen Product Manager

Over the past few decades, the healthcare industry has taken strides in improving safety conditions for workers in surgical settings. One of these advances was the Needlestick Safety and Prevention Act (NSPA) of 2001, which was created to reduce the occurrence of sharps injuries and subsequent exposure to blood-borne pathogens. This legislative effort has led to mandating the implementation of safety procedures, providing education for workers on sharps injury prevention, and requiring employers to identify, evaluate, and implement safer medical devices.

Despite efforts following the enactment of the NSPA, there are still an average of 1,000 injuries per day in the healthcare industry.1  And, although sharps injuries in non-surgical settings have decreased by 31.6 percent, sharps injuries in surgical settings have increased by 6.5 percent.2 

An Uptick in Surgical Setting Injuries
The increase of sharps injuries in surgical settings is troubling, particularly as a large number of personnel – surgeons, residents, nurses and surgical technologists – are present during a single procedure. While a variety of tools are used during each procedure, one of the most common sharps devices used is the scalpel. In fact, more than 75 million scalpel blades are reported to be used each year.3 

The frequent use of scalpels increases the risk surgical personnel face. Reports estimate that as many as 17 percent of sharps injuries are caused by scalpels.4  In fact, a study found that for every 100,000 scalpels used, there were 662 incidences of injury while there were only 3.2 syringe and needle injuries.5  This risk is in part due to the slow adoption of safety scalpels. As of 2010, the use of safety scalpels in the United States was estimated to be less than 10 percent.6  That is staggering, considering the NSPA – which specifically mandated that employers in the healthcare industry identify, evaluate, and implement safer medical devices, including scalpels – was enacted nearly a decade ago.

Although safety scalpel implementation has not been widespread in surgical settings, the safety practice of “hands free” or “no pass” zone in surgical has been adopted by some facilities. This technique has had a positive impact and has aided in the fight to decrease incidents, however, the numbers clearly indicate that current processes are not enough to stem the tide of occurrences and adequately protect healthcare workers from the occupational exposure to blood-borne pathogens that can result from a sharps injury. Although the CDC estimates that 62-88 percent of sharps injuries are preventable by using safer medical devices7 , there has only been a 5-15 percent conversion rate from conventional scalpels to safety scalpels.8 

Recently, Outpatient Surgery Magazine conducted a reader survey to determine how often safety scalpels were used in their facilities. The survey found that 52 percent of respondents said that safety scalpels were never or rarely used at their facilities and 60 percent said that none or few of the scalpels stocked were safety equipped.9  The article stressed that although awareness is expansive, implementation is not. This is because there is no policy in place making safety scalpels mandatory in facilities.

Curious as to why adoption has been slow, we engaged end users and influencers in a series of surveys in order to better understand trends, attitudes and best practices impacting scalpel safety, performance, and adoption. Our team recently conducted this research at the Ambulatory Surgery Center Association’s (ASCA) annual meeting in Dallas, Texas in May 2016 and at the American College of Surgeons’ (ACS) Clinical Congress in Washington, DC in October 2016. The survey, which was distributed to over 200 participants between the two conferences, revealed:

  • Most surgeons are interested in using a safety scalpel
  • The majority of healthcare facilities do not currently provide safety scalpels as an option
  • The overwhelming feeling is that facilities are either generally slow to adopt new technology or they have searched and were unsuccessful in finding an acceptable safety scalpel to replace their incumbent choices

You can learn more about the results of our ASCA survey here and our ACS survey here.

The Need Is Now
As facilities struggle to find adequate replacements for conventional scalpels, personnel are continuing to suffer injuries as a result. These injuries come at a cost – both monetary and administratively. The next post, “Understanding the Consequences of the Injury,” in the series will highlight the consequences and cost sharps injuries have on the workplace.

 

1https://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf
2https://www.cdc.gov/niosh/stopsticks/sharpsinjuries.html
3http://www.ast.org/ceonline/articles/381/files/assets/common/downloads/The%20Economic%20Argument%20for%20using%20safety%20scalpels.pdf
4http://www.ast.org/ceonline/articles/381/files/assets/common/downloads/The%20Economic%20Argument%20for%20using%20safety%20scalpels.pdf
5http://www.journalofhospitalinfection.com/article/0195-6701(92)90005-7/abstract
6https://www.ncbi.nlm.nih.gov/pubmed/20347743
7https://www.osha.gov/SLTC/bloodbornepathogens/evaluation.html
8http://www.hpnonline.com/sharp-points/
9https://www.outpatientsurgery.net/surgical-facility-administration/personal-safety/where-do-you-stand-with-safety-scalpels–05-13&pg=2