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Mandatory Use of Safety Devices for the Prevention of Sharps Injury and Exposure to Body Fluids Statement Health Care Workers that practice with infusion therapy are at greater risk of a needlestick injury or exposure to body fluids. Needlestick injuries and exposure to body fluids can result in life threatening illness, financial, social and emotional costs to the healthcare workers and the health care system. Most injuries and exposures are preventable through the development of strategic plans that include the use of safety engineered sharp, needle free infusion and catheter securement devices. It is the position of the Canadian Intravenous Nurses Association that every employer protects their healthcare workers from job related injury through mandating the use of available devices that have been shown to decrease needle stick injuries and exposure to body fluids. Literature Supporting Potential Harm Far too often, healthcare workers are being injured by contaminated medical supplies either through sharps injuries and/or exposure to body fluids. Healthcare workers can and do contract potentially harmful and/or fatal blood borne infections, that are preventable. Health care workers affected by sharp injuries and body fluid exposures include nurses, physicians, laboratory personnel, and environmental services staff. The Centre for Disease Control Hospital Infections Program, estimates that 600,000 to 800,000 occupational needlestick injuries occur annually. It also estimated that 86% of needlestick injuries can be avoided by eliminating unnecessary needles, using needles with safety devices and using safer work practices (CDC, 1993-1995). Ippolito (1997), has found that transmission of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus (HIV) has occurred
emotional and financial burdens to themselves and their families. cleaning/ collecting of instruments and operative or treatment procedures. 2004)”. 2000). 1999). 2000) Other diseases that can be contracted include: tuberculosis. and typhus (HCHSAO). job replacement.000 sharp injuries per year. The cost to the healthcare system. although secondary. 2 . psychological. in order to protect and improve healthcare workers’ health and safety. the immune status of the worker and the pathogen involved. 2002) (Health Canada. (NIOSH. will increase from treatment.in healthcare workers through occupational exposure. it is important that a change of practice must occur. the Centre for Disease Control estimates that 12. 500 to 600 of them require hospitalization and over 200 die each year (CCOHS. In Canada. Hepatitis B 30%.The Canadian Centre for Occupational Health and Safety affirms that some hospitals are revealing that “one third of nursing and laboratory staff suffer such injuries each year (HCHSAO. 2002). of these. Upon review of the literature and the statistics. 60% of exposures go unreported (Alliance. intravenous insertion. have demonstrated success. Healthcare workers face uncertainty in the possibility of contracting an incurable disease that may include physical. The Canadian Intravenous Nurses Association (CINA) supports the use of safety-engineered devices in providing this type of protection. In the United States. Many institutions have implemented these safety changes. Employment Insurance and potential lawsuits. malaria. To date. with nurses’ accounting for 58% of the total (Alliance. Therefore. herpes. Currently the laws in the United States of America that mandate the use of safety devices and equipment.3%. one case of HIV in Canada can be connected to a needlestick injury. and Hepatitis C 3%. Long Term Disability. 1998b). 190 injuries per day. of those who complied with these mandated changes. healthcare workers incur more than 69. blood collection. Activities that put health care workers at risk include but are not limited to injections. one-quarter of the actual workplaces reported a 51% reduction in injuries (Alliance. Supporting the Mandatory Use of Safety Devices Needle stick injuries and exposure to body fluids will affect the healthcare worker and his/her families’ quality of life.000 health-care workers become infected with the Hepatitis B virus each year as a result of exposure to blood. The risk of infection post sharp injury from a positive source HIV is 0. syphilis. diphtheria. 2002). Unfortunately. Hepatitis C is ten times more transmissible than HIV and there is no vaccine available. Chronic infection develops in almost 75% of the cases (CDC. Using sharps safely has shown to decrease exposure among healthcare workers. The risk of infection varies due to the severity of the injury.
Recommendations CINA believes that nurses and health care workers should not suffer from sharp injuries and exposure to body fluids. which provide shielding or passive protection of sharps that include retractable needles in intravenous (IV) cannulation systems. needle free infusion devices and catheter securement devices are necessary. The current health and safety regulations in Canada need to be re-examined and changed in order to meet the current needs in the healthcare industry. 3 . CINA believes that safety devices need to be effective in preventing accidental injuries. The laws should mandate all healthcare employers to provide these safety-engineered devices such as needle less systems that are approved by Health Canada. These will provide the impetus for protection of healthcare workers within occupational health and safety standards. Catheter securement devices that prevent needlesticks by reducing unplanned catheter restart and prevent exposure of body fluids. Needle free infusion devices. 2004). No longer should healthcare workers be at risk when there exists proven ways to eliminate these hazards by using safety-engineered sharp. CINA encourages all nurses to demand that employers institute a Primary Prevention Program in their workplace for sharps safety and exposure to body fluids. (NAPPSI. by using primary prevention devices. Primary Prevention Devices Primary prevention device technologies include safety engineered sharps devices. Closed infusion systems that decrease the number of connection steps in setting up of intravenous line. We believe that employers must educate employees on how to protect themselves against sharp injuries/exposure to body fluids and to ensure safety engineered devices be utilized correctly. or in intramuscular syringes.Legislation and policies that mandate the use of safety engineered sharp devices. CINA encourages nurses to lobby their employers and government agencies to protect health care workers and their patients from illness and death as a result of exposure to diseases from needle stick injuries and exposure to body fluids. that provide needless intravenous access (luer loc)/blunt cannulation and needless valves/access ports and connectors. needle free and catheter securement devices. throughout their organization. CINA supports and endorses the position paper from the Alliance for Sharps Safety and Needlestick Prevention. Education and training in using these devices is essential to ensure that the safety product is used appropriately and meets its goal of protecting staff. .
References Alliance for Sharps Safety and Needlestick Prevention. Update: (2000). NIOSH.NAPSSI. Surveillance of health care workers exposed to blood/body fluids and blood borne pathogens. Centre for Disease Control and Prevention. V. Health Care Health and Safety Association of Ontario. Paul. CCDR 2001. Recommendations for prevention and control of Hepatitis C virus (HCV) infection and HCV related chronic disease. MMWR 47. (2004).Org. management and chemoprophylaxis of occupational exposure to HIV. 27. (2000). Puro. MMWR 4. Canadian National Occupational Health and Safety Resource Needlestick Injuries. et al. VA. Recommendations to protect health care workers. Primary Prevention Devises. 4-25. Getting the facts about sharps and injury prevention pamphlet. Canadian National Occupational Health and Safety Resource. HHS (NIOSH) Publication.1-10. University of Virginia. 6(2). WWW. 201-12 Health care sector environmental scan and trend analysis 2005-2009. NIOSH ALERT. 1-39. (2000). 4 . CDC. Improving Canadian health care worker safety: The case for mandatory implementation of safety-engineered sharps devices and exposure control plans. (2000). 21-25. Ontario. New York City and San Francisco. Charlottesville. 2000-108. Ippolito. Preventing needlestick injuries in health care settings national institute for occupational safety and health (NIOSH). Summary Report February Health Care Health and Safety Association of Ontario. Health Canada. US Department of Health and Human Services. Evaluation of safety devices for preventing percutaneous injuries among health care workers during phlebotomy procedures. G. International Health Care Worker Safety Center. (1998). 1-7.. 1-6. (1993-1999). 12. (1999). (1997). Publications No. (2002). 108 (11). Hepatitis B. Resource Paper. Toronto: Canada. Prevention. National Alliance for the Primary Prevention of Sharp Injuries. 23-99.18-28. Minneapolis St. (2004). (RR-19). Position Paper. Centres for Disease Control and Prevention..
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