EVERYONE'S RESPONSIBILITY Keep sharps safety an active issue at your facility.

When the Occupational Safety and Health Administration announced plans last year to survey ambulatory surgical centers for their compliance with the federal Needlestick Safety and Prevention Act, I decided that the centers I led should be proactive instead of reactive. This meant gaining — and acting upon — a clear understanding of what OSHA required, instead of waiting for the possibility of a surveyor at the door and then correcting the shortcomings she discovered.

In order to succeed, this effort was going to require staff participation. After reviewing the rules (see "Federal Requirements for Sharps Safety" on page 70) and conferring with our quality assessment and performance improvement committee, I appointed a group of non-managerial employees to select the safety engineered devices we'd be adopting.

The sharps safety committee began its task of reviewing and selecting devices that

• reduced the risk of injuries;
• met end-users' needs; and
• didn't jeopardize patient or provider safety.

We evaluated what we were and weren't using. An accounting of the safety sharps in use at our facilities in light of the wealth of options on the market — scalpels, blunt suture needles, safety syringes, shielded or retracting catheters and needle-less IV systems — showed us the gaps in our practices. We had room for improvement.

The committee members controlled the product evaluation and selection process. Their reviews were based on the safety features each product offered, how well and how easily the products and safety features worked, and how willingly they would use the products. That last criteria carried particular weight, given the resistance that physician preferences and OR culture can put up against change. While the committee agreed that its final selections should be cost-effective, cost wasn't the ultimate factor.

Committee members completed evaluation forms for each product we tested, and these forms were kept, along with documentation of the results and minutes of their meetings, as part of an OSHA-mandated exposure control plan.

When you decide to get proactive about sharps safety at your own facility, consider the following guidelines to support the cause:

• review OSHA's Bloodborne Pathogens Standard and Needlestick Safety and Prevention Act.

• review your current safety plan to assess the elements your sharps safety plan and exposure control plan will need to address.

• appoint staff members to a safety plan development and product selection committee, and ensure open communication with and among them.

• identify and test sharps safety products annually.

• routinely monitor surgical personnel for compliance with the sharps safety plan.

• develop competencies for staff, with education and testing at least annually.

Last but not least, keep sharps safety an active issue at your facility. It's everyone's responsibility. As with any improvement measure, it must be an ongoing process in which the goal is always equipping your staff with safety to ensure quality patient care.

Alcon
ClearCut S Safety Knife
www.alconsurgical.com
(800) 862-5266
List price: not disclosed
FYI: A simple and smoothly activated safety mechanism on Alcon's ClearCut S ophthalmic knife exposes the blade from under a protective hood, locks it in place for surgery and shields it again after use. The ergonomically designed handle features a safety grip for easy actuation and stable control. The single-use blade, available in a selection of types, ensures sharpness with each use.

Angiotech
SharpGuard Guarded Knives
www.sharpoint.com
(877) 991-1110
List price: not disclosed
FYI: Aiming to protect surgical personnel from sharps injuries and blades from perioperative damage, SharpGuard guarded knives feature a sliding, protective sheath that conceals the blade until the user retracts it. This ophthalmic line is available in various slit, paracentesis and crescent blade designs.

ASICO
Unicat Multi-Incision Diamond Knife
www.asico.com
(800) 628-2879
List price: $2,939
FYI: The Unicat Multi-Incision Diamond Knife for ophthalmic surgery has a retractable blade for OR safety, plus 2 additional safety features in the form of Teflon protective caps. One cap over the tip provides a second shield when the blade is retracted, while the other cap at the base of the blade prevents accidental exposure.

Aspen Surgical Products
Bard-Parker Safety Blades and Scalpels
www.aspensurgical.com
(888) 364-7004
List price: not disclosed
FYI: Virtually the same size and weight as conventional scalpels and blade systems, and available with the same Bard-Parker stainless steel blades that surgeons know, these safety blades are quick to load and unload, and incorporate a protective shield that is easy to activate with a single finger by right- or left-handed users.

B. Braun
Introcan Safety 3 Closed IV Catheter
www.introcansafety.bbraunusa.com
(800) 227-2862
List price: approximately $2 each
FYI: From insertion to advancing the catheter to needle removal, the Introcan Safety 3 Closed IV Catheter is designed to avert needlestick injuries. Its fully automatic, passive safety shield cannot be bypassed or inadvertently activated. The multi-access blood control septum provides an additional level of protection against blood exposure. And the integrated stabilization platform minimizes catheter movement within the vessel.

BD Medical
Insyte Autoguard BC Shielded IV Catheter
www.safetybeyondneedlestick.com
(201) 847-6800
List price: not disclosed
FYI: Clinical studies have demonstrated the Insyte Autoguard safety-engineered catheter's ability to reduce the risks of needlestick injuries and blood exposure. A push-button shielding mechanism releases a spring at the user's activation that lets the needle and flash chamber quickly retract into the safety barrel. The 20-, 22- and 24- gauge catheters also feature Instaflash needle technology, which delivers immediate visual confirmation of vessel entry along the catheter shaft.

Beaver-Visitec International
Beaver Safety Cataract Knives
www.beaver-visitec.com
(866) 906-8080
List price: not disclosed
FYI: Available in slit, crescent and sideport blades in a wide range of sizes, Beaver-Visitec's safety cataract knives feature a specially designed and integrated retractable shield to protect the blade (and its handlers) during procedures, in passing and at disposal. The user-activated shield is operated with a spring-assisted slider that provides tactile and audible feedback in the shielded and unshielded positions.

Diamatrix
ProTekt Sharps Safety Knives
www.diamatrix.com
(800) 867-8081
List price: $76 to $275 per box
FYI: Diamatrix has added its patented Snap-Safe handle to its line of ProTekt Sharps Safety Knives. The handle's intuitive design includes a sliding safety sheath that snaps into place and an ergonomic grip. The ProTekt line features blade sizes and configurations to suit any ophthalmic need, including micro-incisional sizes, in single-use or validated multi-use formats.

Oasis Medical
Premier Edge Safety Scalpels
www.oasismedical.com
(800) 528-9786
List price: not disclosed
FYI: The Premier Edge Safety line offers protection, single-handed operation, a ridged handle for non-slip grip and an unrestricted view of the surgical field. The transparent safety guard slides fully over the blade for protection while not in use, and retracts fully onto the handle while the blade is in use. Packaged 6 per box, the knives are available with 15-degree, MVR, 2mm crescent tunnel and slit blades.

Retractable Technologies
VanishPoint IV Catheter
www.vanishpoint.com
(888) 703-1010
List price: not disclosed
FYI: Automated retraction minimizes exposure to the contaminated needle. Clear finger grips and chamber allow for ease of handling and flashback visualization, while a push-off tab enables single-handed advancement and indicates bevel orientation. Color-coded on hub and housing, it's available in a variety of lengths and gauges.

Sandel Medical Industries
Safety Shield
www.sandelmedical.com
(866) 764-3327
List price: $4 each
FYI: Drawing medications from a vial using a needle and syringe can be a risky undertaking. Sandel's Safety Shield provides a protective barrier between the needle and the hand holding the vial. This simple and reusable solution, manufactured under license by Mercy Medical Research Institute, can reduce accidental needlesticks in the OR, pain management clinic, block room or cath lab.

STAY INFORMED OSHA wants you to stay abreast of new sharps safety products.

LETTER OF THE LAW

Federal Requirements for Sharps Safety

OSHA's Bloodborne Pathogens Standard (tinyurl.com/4f8mcwb), which includes the Needlestick Safety and Prevention Act, requires surgical facilities to develop and annually update a written blood-and-body-fluid exposure control plan. One component of this plan is prevention: It should "reflect changes in technology that eliminate or reduce exposure to bloodborne pathogens; and … [d]ocument annually consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure."

In other words, OSHA wants administrators to stay informed with regard to new sharps safety products, for the sake of their employees' safety. "If an effective and clinically appropriate safety-engineered sharp exists, an employer must evaluate and implement it," unless it doesn't meet patient safety and medical integrity standards. Plus, this evaluation must "solicit input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps … and [employers] shall document the solicitation in the Exposure Control Plan."

— David Bernard

Southmedic
Cabo Safety Cartridge
www.southmedic.com
(800) 463-7146
List price: not disclosed
FYI: Southmedic's revolutionary Cabo Safety Cartridge system fits all standard scalpel handles, loading and unloading the same as traditional blades do. The fully retractable sheath allows a clear view of the blade and features the same weight and balance that surgeons are used to. The polymer-coated surgical blades deliver smooth, clean cuts for less tissue drag and better outcomes.

Surgistar
Safety Knives
www.surgistar.com
(865) 671-4300
List price: $80 to $152 per box of 6, depending on style
FYI: With 20 years of experience in ophthalmic cutting instruments, Surgistar offers sharpness and consistency from knife to knife. The company's safety knives also acknowledge OSHA's requirement to adopt sharps-injury-preventing engineering controls with simple, single-handed protection features. Its safety knives are available in stab, crescent, phaco slit and MVR/sideport styles.

Terumo Medical
Surshield Safety IV Catheter
www.surshieldIV.com
(800) 283-7866
List price: not disclosed
FYI: The Surshield Safety IV Catheter's passive safety features require no extra steps to take effect. It has been designed with 2 stages of visual confirmation for peripheral venous catheterizations to safely maximize confidence, first-stick success and patient comfort while reducing the risk of repeated attempts, vein injury and wasted supplies.

Xodus Medical
Safety Scalpels
www.xodusmedical.com
(800) 963-8776
List price: not disclosed
FYI: The stainless steel handles of Xodus Medical's safety scalpels are equivalent in weight, length and shape to those of traditional handles and can be reprocessed using standard procedures. The clear safety blade cartridges, color-coded for easy identification and counting, lock into place, provide full blade exposure and coverage, and have an ejection button. The cartridge blades are available in carbon and stainless steel, in sizes 10, 11 and 15.