Health Science and Medicine: Safe Sharp Mechanisms - Essay Example

Safe Sharp Mechanisms details Safe Sharp Mechanisms Introduction Health promotion has emerged in the last decade as an important factor to improve both the life lives of the sick patients and the nurses who are in charge of taking care of them. Due to the significant increase of accidents that arise from the use of sharp instruments by health workers in which they accidentally injure themselves with this sharp objects while administering medication to patients, we have decided to come up with a concrete health program that will limit the accidents and minimize the spread of infectious diseases from the patients to health workers. Sharp injuries are common risks that are well recognized in the healthcare sector. Medical sharps that are contaminated with a patient blood can transmit pathogens that cause more than twenty diseases of inclusive of the deadly one such as HIV and hepatitis is B and C (Pike 1976). The main aim of this health program is to come up with new regulations and strategies that will supplement the already existing ones in the control and prevention of health issues that arises from sharps injury. In this health program plan we will Ewels and Simnet 2003 planning model to come up with a very concrete and elaborate healthcare program to control and prevent the health care issues that arises due to sharp injuries. Assessment of the Health promotion Needs An effective sharp injury prevention program includes several components that must work in concert to protect health workers in mental institution and other medical centers from suffering injuries that are caused by needlesticks and other sharps (Ewels & Simnett 2003). This program plan is designed to be integrated into the existing infection control, performance improvement and safety programs in the various hospitals that aims at minimizing these tragedies (Linsley & Kane 2011). An institutional review of sharp injuries was conducted to help in determining the priorities in allocation of resource in this sharp prevention program. A review of about two hundred of sharp injuries that occur every year was analyzed and categorized into high, low or moderate. A total of 119 risks were considered to be moderate and the remaining ninety were considered to be at the low risk of acquiring blood borne diseases while the rest could not be categorized (Perry & Robinson 2004). Epidemiological data on sharp injuries incident, including those circumstances that are associated with the occupational transmission of the blood borne viruses, are very crucial elements in targeting and evaluating intervention at the national and local level. The actual magnitude of the problem is difficult to assess because information has not been gathered on the frequency of injuries among the health care workers who work in the other settings such as private medical offices, home healthcare workers and long-term care (Haiduven & simpkins, 1999). Who is at the Risk of Sharp Injuries? Needle stick and sharp injuries remain a serious concern in mainly the health care sector. Research and survey estimate about one million injuries annually in Europe alone (CDC 1989). However a large number of these incidences go unreported. The other workers and personnel that are at the risk of needlestick and sharp injuries are the cleaning laundry personnel, park keepers, polices officers, social workers prison officers and those workers who are involved with waste disposal (Devereaux & Stead 1990). In healthcare, it is not just the medical officers who are at the risk of sharp injuries but all those individual who come in contact with the sharps that are contaminated with body fluids and blood. Majority of sharp injuries affect the nurses because their daily routine revolve around using sharps and needles. The following table shows the comparison of sharp injuries among the various occupations (De Schryver & Claesen 2010). What are the most common causes of sharp injuries? Needlestick or sharp injuries are the generic terms for injuries where infectious body fluids and blood come in contact with wounds or mucus membrane. The most common injuries are cut with medical instrument or needle stick puncture. The other injuries include swallowing a patient’s blood, contamination of broken skin with blood, bites from mental institution patients and contamination by being soaked by blood where the skin is broken. The basic factors that influence the risk of injuries caused by sharps are equipment, the working conditions, the design of the instruments and the working practice. According to the relevant multiple researches it has been observed that these injuries always occur in a stressful, fast paced and understaffed conditions. The health care personnel who work under these conditions are often faced by fatigue, carelessness and poor concentration thus increasing the risk having these injuries. Similarly, it has been observed that sleep deprivation among medical workers who go for the night shifts result in fatigue that further increases the chances of sharp injuries (Tosin & Ciotti, 2010). Identifying hazards and those that are at risk All the sharps injuries are hazardous and could lead to infections of the given victim. In identifying these hazards we focus on what could go wrong or what could cause the harm. Finding the answers to this question is possible by: Identifying the work practices that could cause sharp injuries. Determining the number of workers who are exposed Determine the working practices that have high risk Using the available data on these injuries to identify the areas that at high risk. Evaluation of the risk and priorities In this case we focus our research on what is the possibility of the occurrence of sharp injuries and what will be the implication if the injuries did happen. This is achieved by: Elimination of the risk Collective control measures which include administrative and work place control. Isolation of the hazard which include protective devices Individual control measure which include personal control Deciding on the action of prevention In this stage we ask ourselves, how can the risk of these sharp injuries be reduced or completely eliminated? Taking action This stage mainly involve putting in place the preventive and protective measures and clearly stating who does what and at what time. Monitoring and reviewing of the assessment plan. All the finding of the risk of assessment should be recorded and be part of the plan of minimizing the risk of injuries that could be caused by this sharps. The assessment should then be reviewed and updated when the need arises (Ewels & Simnett, 2003). The Intervention Method Objective and Aims The primary objective of these intervention methods is to develop a good understanding of or to come up with: the best practices for sharps the common risk factors than are caused by sharp injuries the best practice for the safe gloving technique the best method of handling of knifes, needles and other sharps And finally the best practice to prevent the transmission of viruses to the health care workers. The Current Prevention Approaches. In the recent years the Organizations in in healthcare have adopted a prevention model, the hierarchy of control concept that is used by profession in the industrial hygiene to prioritize the prevention intervention (Scriven 2010). In the hierarchy for the prevention of sharps injuries, the initial priority is to reduce and eliminate the use of needles and the use of sharps where it is possible to do so. The next step is to isolate the hazard that is caused by these injuries in which the sharps are protected by the use of an engineering control. In the event that these prevention strategies are not available or does not provide absolute protection, the focus of the prevention control shift to personal protective equipment and work practice control (Martin & Locke 2010). In a nutshell these prevention strategies include: Alternative to using Needles: The healthcare department can eliminate or reduce the use of needles in several ways. Most of the hospitals in the United State of America have eliminated the use of needles by the use the IV delivery system that does not require the access of needles. This technique has largely removed the needles that are attached to the IV tubing such as the ones used for intermittent infusion and the rest of the needles that are used to access parts of the IV delivery system (Baxter & Mitrigotri 2006). The other techniques that are used to eliminate the use of needles in medication are the use of alternative route for administering for medication delivery and vaccination and reviewing specimen collection system to identify opportunity to eliminate unnecessary puncture (Wilburn 2004). Engineering Controls: this method isolate or remove a hazard in the place of work. In the context of sharps injury prevention, engineering controls include disposal of the sharps with an integrated engineered sharp injury prevention feature. The emphasis on the use of engineering controls has resulted into the development of many types of devices that have been engineered with sharp injury prevention features and there are particular requirements for the performance and design of such equipment (CDC 1997). These requirements often requires that the device should be; simple and obvious in its operation, provide a rigid cover that allows the hand to always be behind the needle, ensure that the usage technique is similar to that of the convectional device and have minimal increase in volume that it relative to disposal (CDC 1989). Administrative and Work practice control- Safe work: This technique reduces the likely hood of exposure to the sharp injuries by changing the way work is done. Administrative programs and policies to limit the exposure of sharps injuries by: Effectively adjusting the work schedule and providing adequate staffing Preparing a written statement of health and safety policy Defining the policies that will detail how safe working will be achieved on a daily basis Proving regular training and information Implementing the vaccination policy and programs Training and accessibility to the guidelines should always be available to all workers. The training of workers will involve new recruits, self-employed and ancillary workers, and the staff of the various agencies. Work- practice control are vital adjunct for the prevention of blood exposure, including percutaneous injuries, in surgical and obstetrical settings due to the fact that the use of sharps cannot be avoided (Beekman & Schmitt 1994). Personal protective equipment (PPE) and vaccination: This strategy is often regarded as the least preventive measure. It provides a barrier between the health workers and the actual hazard. It is only applicable when workers exposure to sharp injuries cannot be eliminated by the engineering control and work practices. Example of such practices include the use of masks, face shields, gloves and protective glasses while at work (Martin & Locke 2010). Incident Reporting The injuries that arises due to sharps have been observed to be highly underreported. According to multiple studies it has been observed that the highest level on non-reporting sharp injuries is among doctors, this is primarily due to underestimating the risk and desensitation. According to research, only 35% of the anesthetists questioned were aware of the risk of transmission of deadly virus, such as AIDs, through sharps and needles tick injuries (Dispose & Deakin, 2010). It is a very good practice for the health workers to always report injuries so that the appropriate treatment can follow without delay. This is also important so as to identify the cause of the injury and to take the required step to prevent future injuries. Actions to take in case of an injury. In the event that a health worker suffer sharp and needle stick injuries they should and contaminate themselves with the other body fluids, they should take the following action. Wash splashes off their skin with a lot of running water and soap. Do not suck the wound Alcohol-based solutions and hand rubs can also be used to wash away the contaminated body fluids Cover the wound with a dressing The health worker should record the source of the contamination Check for his or her vaccination status Go straight to a doctor or to the nearest department of hospital emergencies Education and training of the healthcare personnel The best time for training healthcare personnel is during the initial orientation at the work place and the annual blood borne pathogens training that is required by Organisations such as OSHA. The first step on training these personnel is to decide the exact information that each of the training opportunity will provide. The areas that the workers can be informed about during the training process include (Linsley & Kane, 2011). The strategies to reduce or eliminate the use of needles Workplace practices that can be used to reduce the risk of injuries and The use of the available resource to that are used to eliminate the risk Evaluation The process of developing an evaluation plan require several additional steps and it is very paramount to ensure that the evaluation form obtains the desired information and documents the process. After the implementation of these action to minimize sharp injuries there was significant improvement in the number of incidents that occurred. The risks were reduced by 50 percent in a period of six month. The amount of blood borne diseases transmitted to health workers also significantly reduced (Ewels & Simnett 2003). Conclusion Sharps and needlestick injuries are wounds that are caused by needles and other sharp medical instrument. This program has given a detailed explanation about the type of risks that are often associated with the needles tick and sharp injuries. We have discussed the prevention measures such as training, safe injection practices and safe work practices. Similarly it has provided detailed explanation on who is at the risk of sharp injuries and what can be done in case of an injury. The evaluation of this program indicated that there was a significant improvement in sharp injuries due to the implementation of the various actions presented. References Ewels L & Simnett I, 2003. Promoting Health: A Practical Guide, 5th edn: Edinburgh Balliere. Tindal. Pike A, 1976. “Laboratory- associated infections: Summery and Analysis”. Health and LabScience. 13: 105-14 Linsley S & Kane R, 2011. Nursing for Public Health Promotion Principles and Practices. London: Oxford University Press Perry J & Robinson E, 2004. “Needle-Stick and Sharp safety survey”. Nursing; 34(4): 43-7 Haiduven D & simpkins S, 1999. “A Survey of Percutaneous injuries reporting in a public teaching hospital”. J Hosp Infect. 41: 151-4. Collins C & Kenedy D, 1987. Microbiological hazards of occupational needlestick and other sharps’ injuries. 62: 385-402. CDC, 1997. “Evaluation of safety devices for preventing percutaneous injuries among health care workers during Phlebotomy procedures”. MMWR; 46: 21-25 Osborn e $ Papadakis M, 1999. “Occupational exposure to body fluids among students”. Ann Int Med. 130: 45-51 Devereaux H $ Stead W, 1990. “Nosocomical transmission of tuberculosis associated with a draining abscess”. J Infect Dis; 286-95. CDC, 1989. “Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B to health workers”. MMWR. 102: 9-15 Beckman S & Schmitt, 1994. “Temporal association between implementation of universal precaution and a sustainable progressive decrease in percutaneous exposure to blood”. Clin Infect Dis. 18: 526-9 Piper, S 2009. Health Promotion for Nurses: Theories and practices. London and New York: Routlegde. Scriven A, 2010. Promoting Health: A practical guide. London: Bailliere Tindal. Martin C.W & Locke S, 2010. “Protecting health workers from occupational exposure to blood borne pathogens”. The Global Ocupation Health Network- Newsletter. 17: 13-14 EU_OSHA, 2007. “Checklist for the prevention of accidents in labaratories.” Efacts. 20: 16 Baxter J & Mitrigotri S, 2006. “Needle free liquid jet injections: mechanism and application”. Expert. Rev. Med. Devices. 3: 565-574. Tosin W & Ciotti C, 2010. “Needle injury rates according to different types of safety- engineered devices: result of a French multicenter study”. Infect. Control. Hosp. Epidemiology. 31(4): 402-407 Wilburn S, 2004. “Needle stick and sharp Injury Prevention”. Online journal of Issue in Nursing. 9 (3): 5-8 De Schryver A & Claesen B, 2010. “European survey for Hepatitis B vaccination policy for Heathcare Workers”. European Journal for Public Health. 21(3): 338-343. Dispose P & Deakin D. “Ignorance of post exposure prophylaxis guidelines following needlestick injury may increase the risk of seroconversion”. British Journal of Anaestesia. 84(6). 767-770. Read More