McKesson Medical-Surgical Webinar Wednesdays Series

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1 McKesson Medical-Surgical Webinar Wednesdays Series Needlestick Injury Prevention August 12, 2015 Elise M Handelman, RN, BSN, MEd Occupational and Environmental Health Elayne Kornblatt Phillips, RN, MPH, PhD Clinical Associate Professor and Research Program Officer, Univ. of Virginia Amber H. Mitchell, DrPH, MPH, CPH President and Executive Director, International Safety Center

2 Elise M Handelman, RN, BSN, MEd Occupational and Environmental Health Consultant Ms. Handelman is an Occupational and Environmental Health Consultant She is a published author and is affiliated with several recognized universities, including Johns Hopkins University. With a background in clinical nursing and infection prevention, she received her Masters degree in Adult Education from Virginia Technical and State University. She is the former Director of OSHA s Office of Occupational Health Nursing and is an expert on OSHA s Bloodborne Pathogens Standard McKesson Medical-Surgical

3 Elayne Kornblatt Phillips, RN, MPH, PhD Clinical Associate Professor and Research Program Officer, Univ. of Virginia Dr. Elayne Kornblatt Phillips is a Clinical Associate Professor and Research Program Officer in the School of Nursing at the University of Virginia McKesson Medical-Surgical Dr. Phillips received her BSN from Temple University and her MPH and PhD from Johns Hopkins University. She has served on the faculty at the University of Virginia in many capacities, including as Research Director of the International Healthcare Worker Safety Center in the School of Medicine. She recently published a study on healthcare worker risk of sharps injury in the New England Journal of Medicine and in Infection Control and Hospital Epidemiology. She also works internationally and assisted in developing low-cost strategies for reducing healthcare worker risk in resource-limited countries.

4 Amber H. Mitchell DrPH, MPH, CPH President and Executive Director, International Safety Center Dr. Mitchell is the President and Executive Director of the International Safety Center. The Center administers the Exposure Prevention Information Network ( EPINet ) which is the widest used sharps injury surveillance tool used in US hospitals and around the world. Dr. Mitchell s career has been focused on public health and occupational safety and health related to infectious disease. She has worked in the public, private, and academic sectors. Dr. Mitchell began her career as the very first OSHA National Bloodborne Pathogens Coordinator and has received several Secretary of Labor Excellence awards for her work on healthcare worker safety McKesson Medical-Surgical

5 OBJECTIVES Review data on the risk of sharps injury Discuss the importance of preventing bloodborne exposures Explore effective ways to reduce needlestick injury Provide recommended actions to reduce risk of sharps and needlestick injuries

6 Polling Question #1: How would you rate your knowledge about needlestick injury prevention? (Choose one) A. No knowledge of this issue B. Minimal knowledge of this issue C. Some knowledge of this issue D. Better than average issue E. Excellent knowledge of this issue

7 WHY IS THIS A PROBLEM? Over 17 million U.S. healthcare workers are at risk of exposure to bloodborne & infectious pathogens 1/3 of all needlestick injuries are occurring among NON-HOSPITAL workers! Data Source: OSHA & CDC website

8 HOW DOES EXPOSURE OCCUR? Most common: Needlesticks Cuts from contaminated sharps (e.g., scalpels, broken glass, metal, bone) Contact of mucous membranes (e.g., eye, nose, mouth) or non-intact skin with contaminated blood

9 PATHOGENS TRANSMITTED THROUGH PERCUTANEOUS INJURIES Blastomycosis dermatitidis Brucellosis abortus Corynebacterium diphteriae Creutzfeldt-Jakob disease Cryptococcosis neoformans Dengue virus Ebola Hepatitis B Hepatitis C Hepatitis G Herpes Simplex virus Herpes Zoster virus HIV Leptospira icterohaemorrhaglae Malaria Mycobacterioum marinum Mycobacterium tuberculosis Mycoplasma caviae Necrotizing casciitis Plasmodium falciparum Rickettsia rickettsii Sporotrichum schenkii Streptococcus pyogenes Staphylococcus aureus Syphilis Treponema pallidum Toxoplasma gondii Tuberculosis

10 HEPATITIS B Globally: 2 BILLION People 3 MILLION Refugees

11 HEPATITIS C CDC Warns on Rising Cases of Hepatitis C WSJ, May 8, 2015

12 HIV 1.2 Million People in the US are living with HIV. 1 in 5 Don t know they are infected and can pass the virus to others. CDC 2011

13 BBP STANDARD Engineering controls Exposure control plan Frontline Employee input Recordkeeping- add sharps injury log Training

14 EXAMPLES

15 OSHA LETTERS OF INTERPRETATION Remember, selecting a safer device based solely on the lowest cost is not appropriate. Selection must be based on employee feedback and device effectiveness. OSHA Letters of Interpretation Accessed 6/5/14

16 NEW: OSHA ENFORCEMENT IN HEALTHCARE New National Inspection Emphasis Injury & Illness Rate 2X Greater than Private Industry Focus on BBP

17 Polling Question #2: Which of the devices that you use have a needlestick protection feature? A. Injection Needles/syringes B. Blood collection devices C. Lancets D. IV Catheters E. Other

18 SOURCES OF INJURY Which devices cause the most injuries?

19 SOURCES OF INJURY Which devices cause the most injuries? Hypodermic needles account for over 35% of all needlestick injuries EpiNet 2013

20 HOW MANY NEEDLESTICKS HAVE BEEN REDUCED NATIONALLY? National estimate was 384,325 needlestick injuries/year Data source: Phillips EK, et al. Infection Control and Hospital Epidemiology. 2013;34(9):

21 HOW MANY NEEDLESTICKS HAVE BEEN REDUCED NATIONALLY? National estimate was 384,325 needlestick injuries/year Reduction was ~36% Data source: Phillips EK, et al. Infection Control and Hospital Epidemiology. 2013;34(9):

22 HOW MANY NEEDLESTICKS HAVE BEEN REDUCED NATIONALLY? National estimate was 384,325 needlestick injuries/year Reduction was ~36% 138,357 needlestick injuries/year eliminated New national estimate ~245,968 Data source: Phillips EK, et al. Infection Control and Hospital Epidemiology. 2013;34(9):

23 EFFECTIVE INJURY/ INFECTION PREVENTION STRATEGIES 1. Documentation 2. Universal Hepatitis B vaccination 3. Elimination of unnecessary sharps 4. Safety-engineered sharp devices (used!) 5. Safe disposal 6. Personal Protective Equipment 7. Post-exposure prophylaxis

24 TO ERR IS HUMAN bradmontgomery.com

25 COMMON BARRIERS Cost Selection process Resistance to change

26 CO$T A wide variety now available. Cost of the device must be weighed with the expense of a needlestick injury: $800 - $6,000 PER INJURY! AOHP Study: Successfully Reducing Wingset-related Needlestick Injuries, 2014

27 SELECTION PROCESS OSHA requires use of safety-engineered devices

28 SELECTION PROCESS OSHA does NOT endorse, certify or approve devices for use

29 SELECTION PROCESS OSHA does NOT endorse, certify or approve devices for use Selection does not require major research studies in individual workplaces

30 SELECTION PROCESS OSHA does NOT endorse, certify or approve devices for use Selection does not require major research studies in individual workplaces Front-line workers must have input

31 Polling Question #3: Who in your work environment makes the final decision about using safetyengineered devices? (Mark one) A. Office Manager B. Clinical/dental staff C. Physician/dentist D. Corporate purchasing department E. Group Purchasing Organization (GPO) F. Chief Nursing Officer G. Others.

32 WE WOULD LIKE CHANGE TO BE LIKE THIS

33 INSTEAD, WE SOMETIMES FEEL LIKE THIS

34 OVERCOMING RESISTANCE TO CHANGE People Commit to What They Help Create! Discuss Solicit Opinions Include in Decisions Hand Over Decisions Tell/Sell Buy-In and Enthusiasm Peter Bregman, Point B

35 Polling Question #4: What are the top three things that would help you to increase your use of safety-engineered devices? (CHOOSE 3) A. Wider selection of devices what we need is not available B. Ensuring that safer devices are priced competitively C. Management/owner support D. Less resistance to change from staff- they like what they have E. Increased awareness of the risk -- staff members don t believe they are at risk F. Availability of training on the use of newly purchased devices G. Greater enforcement by regulatory agencies (OSHA, Joint Commission, etc.) H. Others..

36 SUMMARY: WHY YOU SHOULD BE CONCERNED ABOUT THE USE OF SAFETY-ENGINEERED DEVICES? The use of safety-engineered devices is required

37 SUMMARY: WHY YOU SHOULD BE CONCERNED ABOUT THE USE OF SAFETY-ENGINEERED DEVICES? The use of safety-engineered devices is required Economically sound decision

38 SUMMARY: WHY YOU SHOULD BE CONCERNED ABOUT THE USE OF SAFETY-ENGINEERED DEVICES? The use of safety-engineered devices is required Economically sound decision Remain competitive in recruitment and retention

39 SUMMARY: WHY YOU SHOULD BE CONCERNED ABOUT THE USE OF SAFETY-ENGINEERED DEVICES? The use of safety-engineered devices is required Economically sound decision Remain competitive in recruitment and retention Enhance marketability of the practice Data Source: OSHA website

40 SUMMARY: WHY SHOULD YOU MAKE CHANGES? It could save your life!!! ( or that of someone around you)

41 QUESTIONS?

42 Thank You! Elise M Handelman, RN, BSN, MEd Elayne Kornblatt Phillips, RN, MPH, PhD Amber H. Mitchell, DrPH, MPH, CPH Unless otherwise noted, the recommendations in this document were obtained from the presenter and Phillips EK, et al. Infection Control and Hospital Epidemiology. 2013;34(9): Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete information. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information. This webinar has been provided to participants on a complimentary basis. McKesson makes no representations or warranties about, and disclaims all responsibility for, the accuracy or suitability of any information in the webinar and related materials; all such content is provided on an as is basis. MCKESSON FURTHER DISCLAIMS ALL WARRANTIES REGARDING THE CONTENTS OF THESE MATERIALS AND ANY PRODUCTS OR SERVICES DISCUSSED THEREIN, INCLUDING WITHOUT LIMITATION ALL WARRANTIES OF TITLE, NON-INFRINGEMENT, MERCHANTABILITY, AND FITNESS FOR A PARTICULAR PURPOSE. The content of webinar and related materials should not be construed as legal advice and is intended solely for the use of a competent healthcare professional. Eligibility Requirements For Participating in a McKesson Webinar: This webinar is not open to the general public. Your participation in this webinar cannot be transferred or assigned to anyone for any reason. You do not have to be a current customer of, purchase products from, or be affiliated with, McKesson, in order to participate in the webinars. McKesson, in its sole discretion, may terminate this promotion at any time. Due to certain regulatory restrictions, this promotion cannot be offered to health care providers licensed in Vermont and/or to government employees. All trademarks and registered trademarks are the property of their respective owners. [2015 McKesson Medical Surgical Inc.

43 Please join us next month! Moving your Lab from CLIA Waived to Moderately Complex Lynn R. Glass, BS, MT (ASCP) VP, Services and Business Development, Laboratory September 9, 2015 at 2:30pm ET