Why Do Needlestick Injuries Still Haunt Us 10 Years after Protective Legislation?

November 8, 2010

By Shawn Kennedy, AJN interim editor-in-chief

By ad-vantage / Vanessa Agressti, via Flickr

In 2008, a survey by the American Nurses Association (ANA) indicated that 64% of nurses reported a needlestick injury. That startling figure was reported by Marla Weston, CEO of the ANA,  in her opening remarks last week when the ANA relaunched “Safe Needles Save Lives,” its campaign for use of safe needles in the workplace. The campaign originally launched ten years ago and was instrumental in passage of Public Law 106-430, the Needlestick Safety and Prevention Act, which requires employers to “identify, evaluate, and make use of effective safer medical devices.” And while there have been inroads towards use of safer needle systems, the 2008 data show that much needs to be done. 

Speaking from experience. Karen Daley, the ANA president, has long been a leader in advocating for safer needle systems. She sustained a needlestick injury while working in the ER a decade ago and contracted hepatitis and HIV infection. Her home state, Massachusetts, has been in the forefront of legislation. According to Angela Laramie from the Massachusetts Department of Public Health, all hospitals in Massachusetts are mandated to use sharps injury prevention devices, maintain a log of any injuries, and submit an annual report to the state. Yet, state data show an average of 3,000 needlestick injuries yearly—and more than half of these are with devices that lack safe needle systems.

Why does this continue? Why can hospitals, clinics, and other workplaces that use sharps continue to not invest in safe devices when they are available and when, by law, their use is mandated? Nurses, does your workplace protect you from needlestick injuries?

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  1. I deal with healthcare professionals around needle free devices on a regular basis. In general, nurses have embraced newer technology but I often see “hold outs” in different areas of the hospital from all professions.
    Until all HCW’s are held to the same standard, problems will remain, whether saftey items are available or not…


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  3. Some devices look safe but are not. Like the fragmin prefilled syringe that requires a tough tug on a rubber-like cover to expose the needle for injection (rebound needle sticks have occurred) but the safety focus is the retractable needle at the end of the injection


  4. The law is NOT restricted to hospitals, that’s correct. OSHA enforces the needlestick safety law. In some states enforcement is by the state OSHA. If your state doesn’t have a state OSHA, federal OSHA does enforcement in your state. (See http://www.osha.gov/dcsp/osp/index.html.)

    As a practical matter, enforcement almost always occurs only when a healthcare worker files a complaint with OSHA. Complaints are kept confidential and workers cannot be punished for filing them.


  5. I agree, but somehow it’s happening. Who is responsible for going out into the community to check, and how is it enforced? I confess, I’m ignorant of the laws governing these offices. The Joint Commission keeps us (hospitals) on the straight and narrow. I’d love some insight.


  6. Re whether other “health providers working independently of a hospital system are not required to follow the same standards as hospitals” – the law does not specify hospitals, but “employers”, so that should mean just about everyone employing nurses, no?


  7. The health system I work for uses and enforces needle safety systems. However, I work in an outpatient facility which admits patients from health care providers outside of our system, and sometimes these patients arrive with ports that are accessed without safety hubers (a specialized, non-coring needle for port access). It is my understanding that health care providers working independently of a hospital system are not required to follow the same standards as hospitals. Whatever, my point is, I work at a hospital facility which supports needle safety, and can still get a dirty stick deaccessing these patients while working there. They don’t have control of independent offices. This may account for some of the problem.


  8. As someone who’s been involved in this issue for more than a decade– albeit from the industry side working with people who develop needlestick safety technology – I think one of the issues is that there are still some needlestick safety technologies that need to be developed yet. One example of a new safety technology (disclosure: I do some consulting for the developer) is the PICC WAND developed by Access Scientific and available through Teleflex/Arrow. It diminishes needlestick safety risk from placing a PICC line. But there are still other devices in other applications that need to be developed. I’d be interested in hearing suggestions from nurses about other areas where needlestick safety technology is still lacking.


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