Reducing Needlestick Injuries from Active Safety Devices: A Passive Safety-Engineered Device Trial
Passive retractable devices significantly lowered NSI risk, improved staff safety perceptions, and demonstrated cost-benefit advantages despite higher purchase costs.
Key Findings
Needlestick reduction: Switching from active safety devices (ASEDs) to a passive safety-engineered device (PSED) reduced subcutaneous needlestick injury (NSI) rates nearly five-fold (from 2.21 to 0.42 per 100,000 employee productive hours).
Trial outcome: Only one NSI occurred during the 9-month PSED trial, and it was attributed to user error rather than device failure.
Nurse feedback: 63–82% of nurses “agreed/strongly agreed” that the PSED was safe, easy to use, and reduced risk. Seventy percent said they would recommend its use.
Concerns addressed: Some nurses noted a visible tiny air bubble and perceived greater patient discomfort; however, no patient complaints of pain or injury were reported during the trial period. Education and re-training resolved these issues.
Cost impact: Conversion to a passive, retractable device resulted in an estimated cost savings of $68,768 due to reduced needlestick injuries.
System implications: Education and training were essential to ensure safe adoption and correct usage.
Conclusion: Passive retractable devices significantly lowered NSI risk, improved staff safety perceptions, and demonstrated cost-benefit advantages despite higher purchase costs.
Abstract/Summary
The authors report a trial comparing a passive safety-engineered device (PSED) with conventional active safety-engineered devices (ASED) in reducing subcutaneous (SQ) needlestick injuries (NSI) among health-care workers. Over a 30-month pre-trial period using ASEDs, they observed 19 NSIs (2.21 per 100,000 employee productive hours). During a 9-month PSED trial period, only one NSI was reported (0.42 per 100,000 hours), a statistically significant reduction (p ≤ 0.05). Root cause analysis attributed the single event to user error rather than device failure. Nurse evaluations of the PSED were positive (52–82% “agree/strongly agree” across device attributes), although some concerns about a visible air bubble and patient discomfort were raised. The cost of PSEDs was higher in direct purchase (net increase ~$20,708 annually), but cost-avoidance from reduced exposures yielded an estimated savings of ~$68,768. The authors conclude that PSEDs can significantly reduce SQ NSI rates compared to ASEDs, and recommend broader implementation with accompanying training, while balancing cost impact against exposure-related savings.
Publication/Source
Spring 2014, Association of Occupational Health Professionals in Healthcare (AOHP)
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