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Healthcare Worker Safety; More than replacing devices April 1 st, 2008.

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Presentation on theme: "Healthcare Worker Safety; More than replacing devices April 1 st, 2008."— Presentation transcript:

1 Healthcare Worker Safety; More than replacing devices April 1 st, 2008

2 Sharps and Needlestick Injury Facts Sharps and Needlestick Injury Facts 70,000 - 107,000 incidents each year in Canada70,000 - 107,000 incidents each year in Canada 10% of incidents are high risk10% of incidents are high risk Incident rate rising – e.g. 136% increase in lost- time injuries in Ontario from 1998 to 2001Incident rate rising – e.g. 136% increase in lost- time injuries in Ontario from 1998 to 2001 58% of sharps injuries are unreported=58% of sharps injuries are unreported=

3 Sharps Injuries have a Serious Personal Impact Sharps Injuries have a Serious Personal Impact 6 – 12 months waiting to know test results – serious impact on individuals and families6 – 12 months waiting to know test results – serious impact on individuals and families Treatment is debilitatingTreatment is debilitating Job impactsJob impacts HCV is a serious health riskHCV is a serious health risk Chronic infection in 75% - 85% of patientsChronic infection in 75% - 85% of patients Active liver disease in 70% of these patientsActive liver disease in 70% of these patients

4 Who has these injuries? Positions CCDR Stats Nurses RN/Assistant/Student 58% Physician15% Phlebotomist5% Housekeeping/Laundry4% Technologist3% Clinical Lab Worker 4% Surgery Attendant 5% Other6% SOURCE: Health Canada: Surveillance of Healthcare Workers exposed to Blood/Body Fluids and Bloodborne Pathogens:. Canadian Needle Stick Surveillance Network 1 April, 2000 to 31 March, 2001

5 When do these injuries occur? WHEN INJURY OCCURRED EPINET % During Use of Item 30.1% Between steps of multi-step procedure 13.7% Disassembling device 4.2% Preparing instrument for re-use 1.9% Recapping device withdrawing from resistant material 3.6% Other after use, before disposal 16.8% Item left on disposal container 0.6% After disposal, item protruding from disposal container 2.8% Restraining patient 0.5% Pierced side of disposal container 0.3%

6 Significant Injury Reduction is Possible Reduction in Injuries: CDC:CDC: 75% reduction in injuries75% reduction in injuries U of Virginia - EPINET:U of Virginia - EPINET: 85% reduction from engineering controls85% reduction from engineering controls 95% reduction from comprehensive approach95% reduction from comprehensive approach Toronto East General:Toronto East General: 80% reduction in total injuries80% reduction in total injuries 100% reduction in blood collection injuries100% reduction in blood collection injuries

7 National Survey - Manitoba First to legislate mandated environment – announced in Sept 04First to legislate mandated environment – announced in Sept 04 Bill 23 – The Workplace Safety and Health Amendment Act (Needles in Medical Workplaces)Bill 23 – The Workplace Safety and Health Amendment Act (Needles in Medical Workplaces) Passed into law effective January 2006Passed into law effective January 2006 Change process is currently underway – 3 year plan lead by WRHAChange process is currently underway – 3 year plan lead by WRHA

8 National Survey - Saskatchewan Minister of Labour announced mandated environment at SFL Congress Sept 04Minister of Labour announced mandated environment at SFL Congress Sept 04 Regulations passed fall 2005 – requirement in 2006Regulations passed fall 2005 – requirement in 2006 Mandates use of SEMD in all workplaces where there is the risk of a sharps injuryMandates use of SEMD in all workplaces where there is the risk of a sharps injury

9 National Survey – Nova Scotia New regulations passed Summer 06New regulations passed Summer 06 –Safe Needles in Healthcare Workplaces Act Mandates use of SEMDMandates use of SEMD Applies to all health care workplacesApplies to all health care workplaces Fines up to $250kFines up to $250k

10 National Survey - Ontario Ministry of Labour conducted audits fall 2004 – generated inconsistent activityMinistry of Labour conducted audits fall 2004 – generated inconsistent activity April 05 Martell tables private members bill mandating SEMDApril 05 Martell tables private members bill mandating SEMD April 05 Min of Health announces $11.6 million one-time funding – funds allocated for every acute care facilityApril 05 Min of Health announces $11.6 million one-time funding – funds allocated for every acute care facility August 07 announcement of regulation (474/07) to mandate use of SEMD – hospitals in 08, all other workplaces in 09August 07 announcement of regulation (474/07) to mandate use of SEMD – hospitals in 08, all other workplaces in 09

11 Quebec, New Brunswick, Newfoundland and PEI Quebec – approach still to be definedQuebec – approach still to be defined New Brunswick – NBNU, NBGEU, CUPE have campaign underwayNew Brunswick – NBNU, NBGEU, CUPE have campaign underway Newfoundland – stakeholder report into MoL + MoHNewfoundland – stakeholder report into MoL + MoH PEI – 100% converted to SEMDPEI – 100% converted to SEMD

12 National Survey – B.C. Leads the Way Updated regulations in 1998. Hierarchy of risk reduction beginning with engineering controls - required the use of SEMD but did not specify thisUpdated regulations in 1998. Hierarchy of risk reduction beginning with engineering controls - required the use of SEMD but did not specify this Fines to VIHA prompted province-wide conversionFines to VIHA prompted province-wide conversion Updated regulations Jan 1, 2008 mandates SEMD – device that provides the highest level of safetyUpdated regulations Jan 1, 2008 mandates SEMD – device that provides the highest level of safety

13 National Survey – B.C. Leads the Way New regulations – highest level of safety and broad definition of biohazards including pandemic influenzaNew regulations – highest level of safety and broad definition of biohazards including pandemic influenza Unique roles and dialogue between stakeholders – BCNU, WorkSafe BC, Health Regions and OHSAHUnique roles and dialogue between stakeholders – BCNU, WorkSafe BC, Health Regions and OHSAH Broad implementation of sharps devicesBroad implementation of sharps devices –Concurrent implementation at FHA WHITE system + VIHA Exposure Control PlanWHITE system + VIHA Exposure Control Plan

14 National Survey – B.C. If more than one type of safety-engineered hollow bore needle or safety-engineered medical sharp is available in commercial markets, the needle or sharp that provides the highest level of protection from accidental parenteral contact must be used.If more than one type of safety-engineered hollow bore needle or safety-engineered medical sharp is available in commercial markets, the needle or sharp that provides the highest level of protection from accidental parenteral contact must be used. Based upon information from manufacturers, independent testing agencies, objective product evaluation, or other reliable sources.Based upon information from manufacturers, independent testing agencies, objective product evaluation, or other reliable sources. Vendors must provide training.Vendors must provide training.

15 BCNU Focus Group Findings 1.Time available to do training and education is compromising change efforts. 2.Management must provide active support for the change process. 3.Successful implementation of sharps safety technology can improve the overall culture of safety.

16 Culture of Safety: Still Much To Do VIHA Survey Statistics: Have you reviewed the VIHA BBF Exposure Control Plan? 20% Have you reviewed the VIHA BBF Exposure Control Plan with your staff? 9% For what percentage of your employees that may be occupationally exposed to blood and other body fluids, do you have documentation indicating that each employee has received specific BBF Education/Training? 25%

17 From adoption to compliance Compliance still inconsistent within certain provinces: e.g. Alberta, British ColumbiaCompliance still inconsistent within certain provinces: e.g. Alberta, British Columbia Challenges within certain areas:Challenges within certain areas: –Pharmacy –Anaesthesia –Nuc. Med., ENT

18 Key Success Factors Executive level leadership/sponsorship is essentialExecutive level leadership/sponsorship is essential Proactive Clinical Leadership (Risk Management and/or OHSS)Proactive Clinical Leadership (Risk Management and/or OHSS) Robust Business PlanRobust Business Plan Implementation plan that considers broader change management challenges. Framed within context of creating a culture of safetyImplementation plan that considers broader change management challenges. Framed within context of creating a culture of safety Strong Education and Training (safety and clinical)Strong Education and Training (safety and clinical) Sharing best practices – creation of reference sitesSharing best practices – creation of reference sites

19 Comprehensive Approach U. of Virginia: 83% reduction from engineering controls. 94% reduction from comprehensive approachU. of Virginia: 83% reduction from engineering controls. 94% reduction from comprehensive approach Elements of Comprehensive ApproachElements of Comprehensive Approach Exposure Control PlanExposure Control Plan Use of Safety-engineered medical devicesUse of Safety-engineered medical devices Training & Education about risks and preventionTraining & Education about risks and prevention Sharps Injury LogSharps Injury Log Post Exposure Control PlanPost Exposure Control Plan Creation of a culture of safety – organizational capacityCreation of a culture of safety – organizational capacity

20 Healthcare Worker Safety; More than replacing devices April 1 st, 2008


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