A Federal Affair
- By Angela Neville, Cynthia Mitchell
- Jan 01, 2001
The issue of needlestick prevention has plagued frontline health care workers for decades. Alternative safety devices along with new legislation is finally moving the United States toward safer grounds, but the road traveled has not been a smooth one.
Know The Facts
An estimated 800,000 needlestick injuries occur each year, and even that large number is considered to be underreported. Registered nurses working at the bedside sustain an overwhelming majority of these exposures. In addition, at least 1,000 of these injuries result in serious infections. The bloodborne pathogens that pose the most serious risks are hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV - the virus that causes AIDS. There also are more than 20 other infections that can be transmitted through needlesticks, including tuberculosis, syphilis, malaria and herpes.
The Needlestick Safety and Prevention Act is the most recent legislation to address this issue. Lawmakers approved the bill requiring health care facilities to use retractable needle syringes or other safety devices to help prevent needle-related injuries. Many groups, including The Service Employees International Union and the American Nurses Association, have pushed the issue for years. They, along with many others, now applaud Congress for its decision to finally address the issue and President Clinton for placing his signature on the bill.
"We are delighted that this item is finally on the national agenda," states Phil Zweig, Communications Director for Retractable Technologies in Little Elm, Texas. Retractable Technologies is the manufacturer of safe needle products. President and CEO, Thomas J. Shaw dedicated more than a decade to developing safety technology resulting in the companies Vanishpoint syringe. The spring-loaded syringe causes the needle to immediately retract into the barrel of the device after the course of the injection. This instant and automatic safety feature not only removes health care workers from contact with contaminated needles, it also prevents reuse of the needle.
An estimated 800,000 needlestick injuries occur each year. |
Safety devices such as the Vanishpoint syringe are widely available. Syringes with guards and protective sheaths still pose a potential danger considering that a large risk factor lies in the recapping of needles. With retractable syringes, health care workers never come in contact with a contaminated needle. "It is both non-reversible and not reusable," said Zweig.
Now that these safer products are available to enable hospitals and health care workers to comply with the law, the government will hopefully continue to be more involved in the issue of needlestick prevention. Zweig also stated that in business, the private industry is typically ahead of the government. In fact, Retractable Technologies' in-house lawyer, Michelle Lareos worked with the Service Employees International Union to draft the California legislation requiring safe needle devices. This legislation became the model for legislation passed in many other states as well as Congress.
"We are very proud of the role we played in not only manufacturing a device that saves the lives of health care workers, but also in providing a basis for the legislation and pushing for it," Zweig said.
In the past, large group purchasing organizations (GPOs) have saved hospitals a lot of money by buying in bulk. As a result, smaller companies like Retractable Technologies have been shut out of the market place due to long-term contracts that hospitals have with GPOs. However, they are not shut out of the public arena. It is the "institutionalized blockage" of the private, acute care side that keeps them out. Zweig feels once people begin to realize that due to this blockage, workers in the public hospitals are more protected than the private sector, there will no doubt be an immense amount of pressure on GPOs. They will then begin to turn to companies like Retractable Technologies for not only needles, but also a whole array of life saving products that are often kept out of the market.
Be Aware of The Risks
NIOSH, The National Institute for Occupational Safety and Health, lists ways in which health care workers can protect themselves from needlestick injuries. An important first step is realizing who is at risk. NIOSH states that "any worker who may come in contact with needles is at risk, including nursing staff, lab workers, doctors and housekeepers." This, of course, includes home health nurses and caregivers.
This instant and automatic safety feature not only removes health care workers from contact with contaminated needles, it also prevents reuse of the needle. |
One of the first preventative steps health care workers can take is to receive a vaccination for HBV. The HBV vaccine has proven itself to be effective in preventing infection in workers exposed to the disease. Unfortunately, no vaccines yet exist for HCV or HIV.
Hepatitis C (HCV), the most frequent infection resulting from needlestick and sharps injuries, is a silent epidemic. There could be thousands of health care workers who carry the disease and do not know it. Regular testing after a needlestick injury is the only way to reduce its spreading.
Out of the 800,000 needlestick injuries that occur each year, 16,000 result in HIV exposure. Along with over 54 documented cases of health care workers with occupationally acquired HIV, there are 35 new cases each year. Recent advances in treatment prolong the time before HIV becomes AIDS, but the drug treatment can cost up to $6,000 per month.
Needlestick injuries are caused by various types of needles particularly hypodermic needles, blood collection needles and suture needles as well as needles used in IV delivery systems. It is important that health care workers always report needlestick injuries to their employer to ensure the appropriate steps are taken in dealing with the injury.
Take Precautions
As stated earlier, there are certain practices, such as recapping needles, that will increase the risk of needlestick injury. Other practices are transferring a body fluid between containers and failing to dispose of used needles properly.
NIOSH suggests the following steps for health care workers in order to protect themselves from injury:
Help Cut Costs
There also is a large cost savings resulting from needlestick prevention. The American Nurses Association reports that hospitals and health care workers in California are expected to save more than $100 million per year after implementing the California Occupational Safety and Health Administration's requirement for safe needle devices. According to the American Hospital Association, an individual case of serious infection by bloodborne pathogens can cost up to $1 million or more for
One of the first preventative steps health care workers can take is to receive a vaccination for HBV. |
expenditures such as testing follow-up, lost time and disability payment. High-risk exposures' follow-up costs are an estimated $3,000 per needlestick injury even when no infection occurs. Safe needle devices cost only 28 cents more than standard devices, and the price is expected to drop with the introduction
of the new legislation.
See The Difference
Due to the fact, that hepatitis B is now preventable along with the steps the government is taking, cases of HBV in health care workers have dropped from 17,000 annually to 400 annually and still continue to decline.
Rep. Pete Stark (D-Calif.) stated in a recent press release that "health care workers shouldn't have to risk their lives while saving the lives of their patients." The goal of the new bill's requirement to use safer needle devices, maintain injury logs and involve health care workers in the selection process of safer technologies is to help make America's health care worker's jobs safer.
"The technology exists today to prevent the vast majority of these injuries. Safe needle devices are used in some facilities across the country, but our bill will make use of safe technology the norm rather than the exception," Stark continued.
Epidemics resulting from the sharing and reuse of needles are a worldwide crisis. The World Health Organization reports that the prevalence of needle re-use varies from country to country, but rates are usually estimated in the range of 15 percent to 40 percent. Some estimates exceed 50 percent. Syringes are widely re-used in countries where injection equipment is scarce but reuse is common in all impoverished countries. This results in the spreading of serious and fatal bloodborne diseases to millions of people each year. Substance abusers sharing syringes also are responsible for the spread of disease. New legislation and a continued attempt in our country to control these diseases will not only set a precedent for other countries to follow, but it will also demonstrate our desire to keep the health care workers of America safe.
This article originally appeared in the January 2001 issue of HME Business.