Through a team-driven quality improvement process, a psychiatric center demonstrated that needlestick injuries are preventable. By combining safer devices, staff involvement, and updated policies, the facility eliminated injuries for two consecutive years while also achieving measurable cost savings.
Baseline review: 16 needlestick injuries over three years pre-intervention (8 in 1994, 3 in 1995, 5 in 1996) prompted a facility-wide project despite relatively low injection volume per injury.
Root causes: Injuries traced to two-handed blood-draw devices/procedures, manual safety (sheathing) IM syringes, overfilled/opaque sharps containers, and contaminated container designs that exposed needles.
Blood-draw devices: A manual needle covering device sets (implicated in injuries) was first replaced by blunting technology, then by retractable blood-draw devices (spring-action needle retraction, one-hand activation), making post-use needlestick nearly impossible.
Sharps containers: Opaque containers that encouraged overfilling were replaced with translucent letter-drop models so staff could see fill level and avoid exposure. Policy set replacement at three-quarters full.
Injection syringes: Manual safety (sheathing) IM syringes (linked to injuries) were replaced with retractable syringes that automatically retract upon full plunger depression, eliminating the need for two-handed actions.
Cost savings: Although retractable syringes appeared costlier at first glance, analysis showed $0.45 savings per injection with the retractable product.
IV safety: The facility also adopted safer IV catheter systems as part of a comprehensive device update.
Policy & monitoring: Leadership monitored for recapping/bending/breaking needles and enforced container replacement at ≤¾ full to sustain safe practices.
Outcome: After interventions, zero needlestick injuries for two consecutive years (confirmed by follow-up and surveillance).
Mohawk Valley Psychiatric Center (200-bed facility) used a quality-improvement approach (plan–do–act–check) to eliminate needlestick injuries. A three-year retrospective review identified unsafe devices/practices as root causes. The facility replaced higher-risk blood-draw devices, resheathable IM syringes, and problematic sharps containers with safer alternatives (including retractable blood-draw devices and syringes, and translucent “letter-drop” sharps containers), updated policies (replace containers at ¾ full; monitor no-recap compliance), and involved front-line staff in selection and rollout. Following these interventions, no needlestick injuries were reported for two consecutive years, and a cost analysis showed incremental savings of $0.45 per injection with the retractable syringe.
Journal of Healthcare Safety, Compliance & Infection Control, Vol. 3, No. 8, October 1999.
