CDC Sharps Injury Prevention Program
CDC Workbook on Sharps Injury Prevention
- Premier's commitment to sharps safety
- Centers for Disease Control and Prevention (CDC)
- Selected CDC initiatives and resources for sharps safety
- CDC NIOSH posters
- Worker training and education
- Order CDC – CD-ROM The Workbook and more resources
- Safety Institute - Research summary of sharps safety devices
Premier’s commitment to sharps safety
Premier has a longstanding commitment to worker safety and through its Safety Institute, provides tools, resources, and education, to assist healthcare organizations eliminate sharps-related injuries. These resources are downloadable on the Safety Institute’s Sharps Injury Prevention Web site.
Premier collaborates with sharps injury prevention stakeholders
The Premier Safety Institute in collaboration with other federal and professional stakeholder organization works with the CDC and other groups sharps safety initiatives to identify gaps in prevention and strategies to eliminate sharps injuries.
Centers for Disease Control and Prevention (CDC)
Background
Needlesticks and other sharps injuries to healthcare personnel (HCP) have been associated with transmission of hepatitis B and C viruses and human immunodeficiency virus (HIV). CDC estimates that every day, over 1,000 hospital-based HCP sustain an injury from contaminated needles and other sharp devices during the delivery of patient care; countless others occur in other healthcare settings such as nursing homes, outpatient clinics, physician offices, and emergency care services. The prevention of sharps injuries in HCP is a national priority as evidenced by federal and state legislation and other regulatory initiatives, including OSHA’s Bloodborne Pathogen standard, requiring the implementation of sharps injury preventive measures.
For more than three decades, CDC has been involved in research and education related to sharps injury prevention, including analysis of injuries, surveillance and data reporting, device analysis, and education and training. Needlestick prevention activities are a collaboration between the CDC’s National Centers for Infectious Disease, Division of Healthcare Quality Promotion (DHQP) http://www.cdc.gov/ncidod/dhqp and the CDC's National Institute of Occupational Safety and Health (NIOSH).
CDC’s resources for reducing occupational risk of bloodborne pathogen, including needlestick prevention are available at:
- CDC DHQP: http://www.cdc.gov/ncidod/dhqp/wrkrProtect_bp.html
- CDC NIOSH: http://www.cdc.gov/niosh/topics/bbp
Recent CDC Activities -Elimination of occupational needlestick injuries
The elimination of occupational needlestick injuries is one of seven healthcare challenges for CDC’s Division of Healthcare Quality Promotion (DHQP). Selected resources are summarized below.
Selected CDC initiatives and resources for sharps safety
CDC national stakeholders meeting
CDC/DHQP created a national multidisciplinary sharps injury prevention coordinating group that included sharps safety stakeholders to discuss trends in sharps injuries and strategies to improve collaboration of sharp injury prevention efforts. One outcome of the group's meeting was the formation of the "National Sharps Injury Prevention Partnership," which included subgroups to target specific issues and assist the CDC in development of an ongoing plan of action to help reduce the incidence of preventable sharps injuries among healthcare personnel.
Proceedings of the National Sharps Stakeholder Meeting
- Download the Proceedings (.pdf) (220KB) or go to:
- CDC Web site http://www.cdc.gov/sharpssafety/
CDC Workbook for designing, implementing, and evaluating a sharps injury prevention program
Summary of the Workbook
The 155 page CDC Workbook is based on a model of continuous quality improvement, an approach that successful healthcare organizations are increasingly adopting. The Workbook provides a program plan that is designed to integrate into the performance improvement, infection control, and safety programs that already exist within healthcare facilities. The program plan also draws on concepts from the industrial hygiene profession, in which prevention interventions are prioritized based on a hierarchy of control strategies. The plan has two main components: organizational steps are listed for developing and implementing a sharps injury prevention program, and operational processes (activities) that are considered vital to the success of a sharps injury prevention program are discussed. The Workbook provides detailed information and a variety of tools (e.g., surveys, worksheets, data collection forms) to facilitate the implementation of organizational steps and development of operational processes. An initial version of the Workbook was launched and available on the CDC Web site in 2004.
Evaluation of the CDC Workbook
Three healthcare systems, a total of eight hospitals, volunteered to participate in a two-year study to evaluate specific components of the
Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention. The findings from this research were presented at national professional association meetings and used to revise the
Workbook.
There was general agreement among the healthcare facilities that that selection of safety devices and strategies to eliminate the risk of occupational needlestick injuries should be guided by input and preferences of front line workers and each institution's data on risks. This includes at minimum, using data from the OSHA-required sharps injury log that contains information about sharps injuries, including the type and brand of device causing injury, location where incident occurred, description of events surrounding injury, such as the procedure being performed and prevention strategies found to be successful.
Additional findings from the research are summarized below and followed by copies of selected research abstracts and information on obtaining the revised Workbook.
Major findings from the Workbook research
Emory Healthcare, Atlanta
- Injuries still occur with the use of "sharps" with safety features. These devices include disposable syringes, butterfly needles, V catheter stylets, vacutainer needles, and scalpels. Factors contributing to injury include:
- Lack of activation of safety feature
- Improper technique used for activation
- Failure of device safety feature
- Lack of activation of safety features reported to be due to lack of training and awareness of importance
- Sharp object injuries can be reduced through the use of safety devices and work practices, including blunt sutures, protective corks on surgical wires, and a neutral zone for passing sharps. Training on appropriate use of the device and activation of the safety feature is an essential component of the program to eliminate needlesticks and sharps injuries.
Grady Memorial Hospital, Atlanta
- Availability of rapid HIV- testing of "source" patient results in fewer workers unnecessarily being started on HIV chemoprophylaxis.
Detroit Medical Center, Detroit
- Root cause analysis is a useful tool to identify the cause of sharps injuries
Detroit Medical Center, Detroit MI and CDC
National Center for Infectious Disease, Division of Healthcare Quality Promotion,
Centers for Disease Control and Prevention
- Respondents with a positive perception of the organization’s safety culture are less likely to sustain a sharps-related injury. Examples of positive safety culture perception include the belief that patient safety is never sacrificed to get more work done and the organization encourages and rewards the recognition and reporting of errors and hazardous conditions.
Research Abstracts
- "Relationship Between Hospital-Based Healthcare Personnel Perceptions of Safety Culture and the Occurrence of Sharps Injuries." Authors: Grytdal, SP; Kobeski, A; Kaplan, C; Flanagan, E; Cousin, P; Lundstrom, TS; Beltrami, EM; Pearson, ML. Presented by S. Grytdal at Association for Professionals in Infection Control and Epidemiology (APIC) Annual Conference, 2006 (oral presentation)
- "Sharps Injury Prevention Program: Root Cause Analysis of Sharps Injury or Near Miss Event at a Multi-Facility Medical Center." Authors: Flanagan, E; Semproch, L; Preney, K; Chevalier, T; Lundstrom T. Presented at Association for Professionals in Infection Control and Epidemiology (APIC) Annual Conference, 2006 (poster presentation)
- "Reduction of Sharps Injuries in the Operating Room Following Implementation of a CDC-Recommended Sharps Injury Prevention Program." Authors: Berry, X.; Voris, V.; White, N.; Salomone, J.; Diaz-Granados, C.; Dent, L.; McCoy, J.; Feliciano, D.; Blumberg, H.M.; Ray, S.M. Presented at Society of Healthcare Epidemiologists for America (SHEA) Annual Meeting, 2007 (poster presentation)
- "Sharps Injuries Occurring With the Use of Safety Devices: Providing Safer Devices Is Not Enough." Authors: Walker, C.; Robichaux, C.; Desroches, P.; Berry, X.; Ribner, B.; Ray, S.; Blumberg, H.M.; Diaz-Granados, C.; Steinberg, J. Presented at Society of Healthcare Epidemiologists for America (SHEA) Annual Meeting, 2007 (poster presentation)
- "Acceptance and Completion of HIV Post-exposure Prophylaxis by Healthcare Workers Following Blood and Body Fluid Exposures." Authors: Berry, X.; Ray, S.M.; White, N.; Voris, V.; Diaz-Granados, C.; Sanchez, M.; Del Rio, C.; Blumberg, H.M. Presented at Society of Healthcare Epidemiologists for America (SHEA) Annual Meeting, 2007 (poster presentation)
CDC NIOSH posters on needlestick prevention for healthcare settings
- Download posters
Worker training and education
- CDC Sharps safety education pamphlet for healthcare professionals. 2-page tri-fold; easy to download and print.
2-page pamphlet (.pdf) (335 KB) - Premier Safety Institute's needlestick brochure 12-page, easy-to-read brochure for worker training
12- page brochure (.pdf) (925 KB)
CDC Workbook for designing, implementing, and evaluating a sharps injury prevention program
- Download a copy of revised (2008) workbook
- Order 2008 workbook on CD-ROM, including workbook, video, educational slides, posters, and 2-page CDC worker training pamphlet from the Safety Institute store.
The Stakeholders meeting, the research evaluating the CDC Workbook, dissemination of the sharps safety posters and CD-ROM was funded by the CDC Foundation with an unrestricted education grant from the Safety Institute, Premier healthcare alliance
Premier Safety Institute---Research summary of sharps safety devices
- Summary of articles from 1987 to 2008 on , selection, testing or evaluation of safer needle devices
Device research