In what is claimed to be a systematic review and evaluation of the efficacy of ‘safer sharps devices’, HSE have recently published this work from HSL.
We are all well aware that sharps-related injuries carry the risk of serious bloodborne infection. HSL thus ran a systematic review to consider the evidence related to safer sharps devices and their impact on needlestick injury reduction within the healthcare sector. The review sought to determine whether:
- the use of safer sharps devices could reduce the incidence of sharps injury
- dedicated educational / training initiatives could reduce the incidence of sharps injuries
- safer sharps devices were accepted by the hospital personnel asked to use them, and
- safer sharps devices had any proven impact on patient care outcomes
The quality and quantity of evidence was limited, mainly due to study designs used by publishing authors. Despite this, there was sufficient published evidence to consider the use of safer sharps devices to reduce the incidence of sharps injuries amongst UK healthcare workers.
Disposal and the environmental impact of a substantially greater amount of plastic and, for some devices, or metal also, was not considered and possibly not understood. In particular, the need for an active device that automatically retracts the needle to a safe position after use was not considered. This is particularly important since the passive devices that require the user to take additional steps to cover the needle may well be discarded without activation. At worst, those healthcare workers to take insufficient care in disposal and drop used needles and syringes into waste sacks and laundry bags etc are unlikely to activate a safety device before doing so. Thus, the problem remains.
Studies showed that when educational programmes were implemented alongside a safer sharps device, lower rates of sharps injuries were sustained for longer. However, the benefit attributable to education alone could not be isolated from the impact of the introduction of the safer sharps device.
Few studies have investigated user acceptability of safer sharps devices and patient outcomes, and more studies are required to assess these areas with greater certainty.
Sharps-related injuries carry the risk of serious blood borne infection. A systematic review was undertaken to consider the evidence related to safer sharps devices and their impact on needlestick injury reduction within the healthcare sector. The review sought to determine whether:
- the use of safer sharps devices could reduce the incidence of sharps injury;
- dedicated educational / training initiatives could reduce the incidence of sharps injuries;
- safer sharps devices were accepted by the hospital personnel asked to use them; and
- safer sharps devices had any proven impact on patient care outcomes.
The quality and quantity of evidence was limited, mainly due to study designs used by publishing authors. Despite this, there was sufficient published evidence to consider the use of safer sharps devices to reduce the incidence of sharps injuries amongst UK healthcare workers.
Studies showed that when educational programmes were implemented alongside a safer sharps device, lower rates of sharps injuries were sustained for longer. However, the benefit attributable to education alone could not be isolated from the impact of the introduction of the safer sharps device.
Few studies have investigated user acceptability of safer sharps devices and patient outcomes, and more studies are required to assess these areas with greater certainty.
HSE distance themselves from any criticism of the document with their usual disclamer:
This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.
This is no doubt standard business practice. However, it does remind me that even now HSE refuse to include sharps injury in the mandatory reporting required under RIDDOR. Only when that happens will meaningful statistics be obtained to identify the true scale of sharps injury, the circumstances of those injuries and the deficiencies in design, practice and education that create the opportunity for those injuries.
Until HSE take responsibility, their work toward teh reduction of sharps-related injury remains wholly undone.
http://www.hse.gov.uk/research/rrpdf/rr914.pdf