Enhancing Surgical Safety: Integrating Sharps Injury Prevention into Your OR Checklist

A surgical safety checklist is a cornerstone of perioperative practice, fostering safety behaviors, improving team communication, and enhancing risk awareness. Dr. Michael Sinnott, MBBS, FACEM, FRACP, a leading advocate for sharps injury prevention, believes incorporating specific sharps safety checks can significantly reduce these preventable yet persistent risks. This article explores how to strengthen your surgical safety checklist to protect both patients and OR staff. 

The Critical Need for Sharps Safety in the OR 

Recent data highlights a concerning trend: sharps injuries are on the rise. Dr. Sinnott, an emergency physician and co-founder of StaffandPatientSafety.org (SAPS), has witnessed the impact of these injuries firsthand. From a suture needle stick to a scalpel slip, the consequences can range from minor discomfort to severe injuries requiring surgical intervention. Beyond the immediate physical harm, sharps injuries pose a risk of bloodborne pathogen exposure for both patients and staff and can disrupt surgical procedures. Despite these risks, sharps safety practices are often overlooked and underreported, with an estimated 50% of sharps injuries going unreported. This lack of awareness underscores the urgent need for a broader team conversation about sharps safety checks. 

Bridging the Sharps Safety Gap: A Four-Step Approach 

Dr. Sinnott emphasizes that regular review and refinement of your surgical safety checklist are crucial for prioritizing both patient and staff safety. Based on his extensive experience working with surgical teams, he recommends a four-step approach to integrate sharps injury prevention: 

1. Open the Dialogue: Discuss Sharps Risks and Underreporting
   Initiate a team discussion about the prevalence and potential consequences of sharps injuries. Share relevant data, review past incidents (while maintaining confidentiality), and address the issue of underreporting. Highlight the connection between staff safety and patient safety, emphasizing that a safe work environment is essential for optimal patient care.

2. Conduct a Comprehensive Checklist Review: Identify Gaps and Opportunities
   Examine your current surgical safety checklist to identify missing elements related to sharps safety. This review should involve gathering input from all members of the surgical team, including perioperative nurses, surgeons, anesthesiologists, and technicians. Analyze patient and staff injury data to pinpoint areas for improvement. Consider the availability and consistent use of engineered sharps safety devices. 

3. Listen to the Experts: Value Perioperative Nurses' Insights
   Perioperative nurses are often at the forefront of patient care and possess invaluable insights into OR safety practices. Dr. Sinnott stresses the importance of actively listening to their experiences and recommendations. Discuss team dynamics and workflow to identify the most effective ways to integrate sharps safety checks into the existing checklist. 

4. Implement and Trial: Integrate Sharps Safety Checks into the Checklist
   Based on the review and feedback, determine specific sharps safety checks to add to your surgical safety checklist. Consider incorporating checks at various stages of the procedure: 
   • Sign-In: Confirm the availability and readiness of required engineered sharps safety devices. 
   • Time-Out: Discuss how sharps will be handled during critical moments of the procedure. 
   • Sign-Out: Confirm if any sharps injuries occurred and ensure proper reporting procedures are followed. Emphasize the importance of reporting all injuries, regardless of perceived severity, due to the risk of bloodborne pathogen exposure. 

Continuous Improvement: Fostering a Culture of Sharps Safety 

Integrating sharps safety measures into a surgical safety checklist is an ongoing process, not a one-time solution. Dr. Sinnott emphasizes the importance of continuous testing, monitoring, and assessment.

“Clinicians, by nature and nurture, have almost always prioritized their patients’ safety over their own safety,” Dr. Sinnott said. “This is often reflected in patient safety systematic improvements that are disconnected from staff safety improvements.” 

He said by investing time and resources in integrating staff safety alongside patient safety, healthcare organizations can achieve a truly unified goal: "One Safe Culture for All."

Guideline Resources - Sharps Safety

Learn how the guidelines can help your team prevent sharps injuries and reduce bloodborne pathogen exposure from medical devices by handling and disposing of them properly. (member-only)