Employees of the healthcare industry are perpetually exposed to the dangers of contagious diseases and other collateral side-effects of having to work in an environment of illness. This is especially true when it comes to nurses and assistant staff. This is not a recent suspicion – for as long as there have been people caring for the sick, there was always the risk of being infected by the carrier. It’s just a natural fact that nurses and healthcare staff are prone to being victims of the very affliction they aim to cure, care for, and alleviate.
One of the most dangerous and alarming vehicles of infections from patients or subjects to healthcare workers is the injection syringe. The syringe is exposed to the body parts and fluids that carry the causes of viral or infectious diseases, and since it is almost effortlessly easy to accidentally prick oneself with these said syringes with even the most inconspicuous carelessness, needle-stick injuries, as they are most popularly known as, are a drastic cause of occupational accidents in the healthcare industry. In the United States alone, about 800,000 cases of needle-stick and percutaneous accidental injuries are reported every year, mostly a result of handling sharp and penetrative equipment and tools (Allen, 2007). These have huge implications on matters such as employee wellbeing, safety, insurance and safety policies, and even the issue of disease and epidemic control. Just some of the terrible diseases that can passed on to healthcare workers from ill patients include Acquired Immune Deficiency Syndrome (Porter, 2000) and Hepatitis B and, according to recent case studies, Hepatitis C (Trangle, Adebowale, & Fallon, 2006). Moreover, the list of infectious diseases that can be passed on through needle-stick injuries via blood-borne pathogens is countless.
With that in mind, it is absolutely important to have a policy within a certain medical institute or health centre in order to ensure the safety of healthcare workers within the prevention of needle-stick injuries. An overworked nurse or a healthcare worker rushing to save a life can contract fatal diseases by committing almost unavoidable mistakes in such conditions. For both the benefit of the healthcare workers and the control of infectious diseases in a community, a hospital, clinic, and other institutes must implement a safety regulation and system in order to preserve good health within the immediate environment.
Background of Percutaneous Accidental Injuries
Research studies in the field of healthcare industry safety are abundant, and it is for this reason that it is easy to ascertain the extent of percutaneous injuries’ impact on the administrative level. Industry awareness (at least in North America) pertaining to these categories of injuries reached a critical point when the Needle-Stick Safety and Prevention Act of 2000 was implemented, which became effectively enforceable the following year (Murphy, 2004). This act made the use of safety devices that prevented accidental percutaneous injuries, especially in the handling of syringes, compulsory. With these policies in place, it made injuries and accidents much more controllable than before with through the proper management of a medical institution’s processes (Murphy, 2004).
According to a research conducted with twenty-two different hospitals, it was revealed that several factors were held responsible to accidental injuries within the workplace (Allen, 2003). Perceptions regarding risk and diseases borne by blood and bodily fluids all play roles in awareness and behaviour. The study revealed the following behavioural findings (Allen, 2003):
More than 85 percent of nurses reported following safety procedures and wearing gloves while working in environments where exposure to pathogens was significant
Approximately 48 percent of healthcare employees believed emergency situations and rushing was a factor in workplace injuries
Approximately 40 percent of healthcare employees believed difficult and uncooperative patients were a factor in workplace injuries
Approximately 26 percent of healthcare employees believed the carelessness of physicians was a factor in workplace injuries
These research findings revealed that a majority of healthcare staff complied with safety regulations, but with so many uncontrollable situations wherein a nurse or a staff member is almost helpless to the circumstances, injuries are the effect of external causes.
The Report Issues
The objective of the report is to strategize a system that is to be implemented into a hypothetical model hospital in order to prevent and decreases the rates of needle-stick injuries amongst healthcare employees. In order to address the issue more effectively, a PICO analysis must place the issues in perspective. The following will reveal the true intentions of this study:
With this issue, the patient to be considered of concern here are internal. That is, the subjects that are affected by the issue of needle-stick injuries are healthcare workers. However, the problem also drastically affects patients with contagious diseases, since they are the carriers of the root “problem”.
Introduce needleless syringes into hospitals and clinics, as well as the introduction of a Syringe Accident Prevention program in order to eliminate the alarming issue of needle-stick injuries.
The problem with countless medical institutions and centres around the world is that most of them still use multi-use needle syringes. Furthermore, there is very little education and awareness to the dangers of needle-stick injury amongst developing and underdeveloped countries. This is highly conducive to accidental injury.
The expected outcome of this intervention is to reduce (if not to totally prevent) the rates of needle-stick and percutaneous injuries amongst healthcare employees around the world.
With the PICO analysis complete, the question that this report aims to address is: “Will the introduction of safe equipment and procedures greatly reduce the number of needle-stick injuries amongst healthcare workers?” Using this issue as a foundation for the report, we now look to outside sources and studies to come up with conclusions and recommendations.
Search Terms Used for Resource Acquisition
Using several online databases (including Gale Group databases such as the Health and Wellness Resource Centre), the author of this report managed to acquire some very instrumental literature published by industry professionals and refereed publications. Some of the parameter key terms used include: needle-stick prevention, percutaneous injury, the Needle-Stick Safety and Prevention Act, healthcare safety, and several others. A bibliography at the end of the report will provide a comprehensive listing of the resources used to create this report.
Critical Appraisal and Article Review
Most of the published literature available usually refers to needle-stick injuries as a consequence of badly managed and organized process inside medical institutions. But the reason such a superficially minor injury is considered so dangerous and detrimental to the health and welfare of registered nurses and other healthcare workers and employees. Infectious diseases and other blood-borne pathogens are not only extremely dangerous to the community, but can be fatal to the needle-stick injury victim (Ferguson, 1992). Some even go as far as stating that rare injuries, such as Hepatitis C, are on the verge of become common amongst healthcare workers and staff due to improper use of syringes and sharps (Trangle et al, 2006). Moreover, all this negligence to safety and lack of infrastructure to the best practise of medical procedures are usually not at the hands of the people practicing them. In such a case, the only possible line of defence against injuries sustained during very stressful conditions and circumstances are management guidelines which can record and prevent such awful injuries and accidents.
Most of the suggested managerial measures already published and probably already put in place by innovative and well-organized medical institutions all state the importance of recording the time, place, and circumstances of needle-stick injuries (Hutin et al, 2004). This is extremely vital because of the importance of intelligence and information regarding the nature of such injuries. Furthermore, the non-existence of these measures also mean that the generous chunk of the actual cases of needle-stick injuries occur without being reported and usually go unnoticed and untreated until it leads to some far worse scenario (Allen, 2007).
It must be kept in mind, however, that most industry professionals and think-tanks believe that the best way to prevent and resolve the issue of needle-stick injuries is the introduction of technology specifically and especially designed for the exact same circumstances that cause these percutaneous injuries in the firs place. The following section of the report (the business plan) will elaborate on the several technologies available for the prevention of needle-stick injuries, most notable of all, the blunt-tip singes (Ogg, 2007, Wise, 1997).
The importance of creating a business plan for a medical institution in order to prevent or, at least, reduce the number of incidents pertaining to needle-stick injuries lies in the case studies we read about from poor and underprivileged countries and communities around the world. Sub-Saharan, East, and West Africa have some of the worst cases of negligence within the field of medical practice. This is mainly due to the fact that most hospitals and clinics in the area are usually charity-based, and therefore, mostly consisting of volunteers. Combine this with the two most important factors attributing to injuries in the workplace – lack of technology and budget, and extremely stressful and uncomfortable working conditions – will most definitely lead to higher rate of workplace injuries, especially needle-stick and percutaneous ones (Dicko et al, 2000). Therefore, because hospitals in the developed and developing world are more capable of implementing safeguard procedures than their underdeveloped counterparts, they must. They should because they can.
The Importance of Introducing Safer Products and Safety Training Programs – A Business Plan
Everyday in the United States, about 5 million healthcare employees are at the risk and mercy of blood-borne pathogens that could transmit dangerous diseases (Gordon, 1998). The most important contribution a medical institution can make to the wellbeing and safety of both its patients and its employees is the introduction of safer products and holistic training. By making products that make practicing healthcare safer available to both physicians and assistant staff (i.e. nurses), avoiding injury not only becomes easier, but becomes an effect of using such products (Perry, 2000). Furthermore, the provision of educational training to employees increases awareness and endows the said employees with the knowledge to practice safe and approved procedures. Having one of two goes a long way in the reduction of workplace accidents, and when equipped with both, employees become much more aware and professional about the way they do things under various, difficult circumstances.
Moreover, the lack of proper managerial systems to oversee risk management sees approximately 60 to 95 percent of pathogenic exposure amongst house staff (Ferguson, 1992). This means that the figures can be misleading, yet it does reveal a very alarming need for creating managerial safeguards that make it mandatory to report any incidents, no matter how remote. The simple solution to this is awareness and a sound human resource management system that healthcare employees wouldn’t hesitate to approach.
According to publications by the World Health Organization, the average rate of injections annually is about 3.7 per person (Hutin et al, 2003). This startling figure gives us an insight into how many accidents could happen every year around the world, especially in places where hospital equipment and budget are both under heavy constraints. Most of the already implemented safety procedures are usually enforced by governmental organizations, such as the Food and Drug Administration of the United States, who have made it a point to make needleless systems become a norm in most hospitals within the country (“FDA guidance on sharps…”, 1994). However, with developing countries, government regulation and control isn’t always backed with budget and action. This can leave hospitals, clinics, and other medical institutions helpless amidst calls for system reorganization.
It is excessively clear that the introduction of both equipment and or training can make a huge difference. And even though it can hurt the institution’s budget, the implementation of such changes in the system need not necessarily be done so for every department and process of the hospital. Starting out slow and gradually can make a very substantial amount of difference in the wellbeing of healthcare employees.
Implementing the Change
Manufacturers of syringes and other medical equipment have made it a point to make their products conducive to safe medical procedures and processes. Products used in intravenous procedures are usually divided categories: blunt cannula systems, one-piece swabable adapters, and non-swabable valved systems (Wise, 1997). These are largely used by hospitals around the world. On the other hand, hospitals and clinics in developing and underdeveloped countries (the point is amplified when talking about charitable medical institutions that run on donations and grants) might not always be able to afford such equipment. That is why injuries relating to injections are excessively high for both patients and healthcare workers. A study has revealed that in West Africa, injuries to patients due to unprofessional medical procedures are approximately 231 for every 100,00 (Dicko et al, 2000). For that matter, educational and training programs can fill in the gaps.
Approximately 20.5 percent of all needle-stick injuries that happen in hospitals are attributed to suture needles (Ogg, 2007). Introduction of blunt-tip suture needles have greatly reduced the number of injuries that happen within the hospital setting. In a study by the Centers for Disease Control and Prevention, findings revealed that the usage of these blunt-tip suture needles resulted in no injuries, while the conventional suture needles was responsible for 92 percent of needle-stick injuries (Ogg, 2007). This vast, measurable difference means that the introduction of syringe equipment can mean the difference between the wellbeing of employees and their infliction with fatal disesases.
The World Health Organization has published guidelines on how to better reduce and prevent the rate of needle-stick and percutaneous injuries amongst healthcare staff. Some of them include the following (Hutin et al, 2003):
Eliminate the use of needles in procedures that don’t necessarily require them
Make sure that the injection equipment used in a procedure is sterile
Have the equipment stored and used in an environment wherein contamination is difficult, if not outright impossible
Avoid recapping of needles
Make sure the patient to whom the injection will be delivered will not make sudden movements
Prevent the use and or access of needles that have already been used (since most hospitals and clinics in poorer regions of the world will use multi-use needles)
Introduce innovations that were designed to prevent accidents and injuries
Make the use of gloves absolutely mandatory
The implementation of mandatory hand hygiene
These guidelines are what the WHO sees as the basic foundation of safety policies within hospitals around the world. These could serve as the fundamental structure of the educational program that is to be implemented in a model hospital.
By training healthcare employees with the use of innovations in syringe technology, they will be more than ready to take on any new introductions in the alteration of the equipment they use. Training programs in the forms of weekend seminars (which should be made mandatory for all RNs) will ensure that nurses, old and new, will not forget the dangers associated with the use of needle syringes. The purpose of such programs is to instil perceptions of danger and care when using non-needleless systems with patients. Furthermore, programs based on the findings mentioned earlier should also be implemented; that is, emergency situations, uncooperative patients, and careless physicians (Allen, 2003). Training registered nurses how to cope with such situations will reduce injuries during these said circumstances less likely to occur than otherwise. As it is, recapping needles account for about one-third of all needle-stick injuries that have been reported (“Needlesticks: preaching…”, 1992). This means that the operation of needles itself can contribute to most of the injuries itself, and training employees to operate them in a safer procedure can definitely cut back the unfortunate injuries.
The final component of the educational and safety management system includes a risk assessment policy. Needle-stick injuries is considered the second largest cause of injuries within hospitals, only beaten in figures by accidental “falls” (Briant, 2003). By having staff log and record every needle-stick injury and where and when they took place, they will be able to identify which setting and time these injuries are more prone to happen. In doing so, they will be able to implement safety procedures that actually adapt to evolving situations as the typical day progresses. Recoding injuries and their circumstances are absolutely vital to their very prevention.
Implementation of these programs cannot work on its own. These strategic plans must be communicated throughout the whole institution, and a preach-by-practice philosophy must be the driving force behind this progressive advance into a safer working environment.
Injuries due to factors that are usually out of the hands of the typical healthcare employee cannot be attributed to their carelessness. Institutional administration and managerial levels know more than anyone else that the hospital environment can be very stressful and tiring, and registered nurses and other healthcare staff must be given whatever help they need to simply work without injury. This case should be even more important to the decision-makers because they are absolutely detrimental t the control of contagious diseases, which works against what the healthcare industry seeks to do.
In any case, the feasibility of the business plan heavily relies on an important concept – the prevention of injuries and other mishaps through new management and budget implementations are much cheaper to deal with than the consequences of a negligent and unsafe working environment, which can ultimately lead to injury, turnovers, and possibly death. In such a situation, the choice is obvious, and most importantly, the ethics are much more clear-cut. One of the aims of a well-organized institution after all is the wellbeing of its workers and professionals.
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