2003 Sharps Injury Prevention Award Winners

The 2003 International Sharps Injury Prevention Awards

By Ron Stoker - Executive Director, ISIPS, International Sharps Injury Prevention Society

December 2003 - Managing Infection Control

In the October issue of Managing Infection Control, Drew Whitney, in her editor's letter, shared with us the story of clinicians who don’t always wash their hands before treating patients, reminding us of our responsibility to make sure that “our” physician and nurses practice proper hand hygiene before examining and treating patients. I have a similar story to share.

I had blood drawn during some recent visits to several physician offices. I watched intently to see what equipment was used on me. At the first physician office no safety equipment was used. As the phlebotomist pulled the needle out of my arm and then removed it from the blood collection holder and dropped the needle into a sharps disposal container, I asked her, “Did you know that what you just did is illegal?” Her eyes opened wide as if she was afraid that I was going to report her. I indicated that I was only hoping to make her aware of the requirements of the law, and I gave her my business card and a photocopy of the OSHA requirements.

“Do you always carry OSHA requirements when you come to the doctor’s office?" she asked.

Yes, actually, I do. I have found that although many hospitals have made the conversion to safety that the rate of compliance at individual physician offices is much lower.

We need to help each other to know and meet the requirements of the law--not just because it is the law but because it helps to protect healthcare workers and others from deadly diseases.

Ignoring poor healthcare practices is like driving down the highway, following a car that is weaving from one side of the road to the other, and just ignoring it. Reasonable people do not just ignore drunk drivers--they get out their cell phones and call 911 to inform the authorities that there is a drunk driver on the road. Similarly, we should be prudent in helping fellow healthcare workers understand the requirements of the law as well as giving them an understanding of safety equipment that we have found helpful.

This year, Managing Infection Control and ISIPS are being joined by a variety of healthcare organizations in commemorating the 2^nd Annual International Sharps Injury Prevention Awareness Month. We invite your hospital or healthcare organization to initiate similar activities that will help spread the word of sharps injuries and bloodborne exposure prevention.

In every field of human endeavor, there are those who are at the forefront making a difference with their lives and energy. The International Sharps Injury Prevention Society (ISIPS) and Managing Infection Control believe that many deserving candidates have dedicated years to expanding our collective knowledge and understanding of needlesticks and other sharps injuries and helped to devise methods to prevent these injuries.

We thank those individuals that have made a difference in getting the message of sharps injury prevention out to healthcare workers and employers around the globe. We owe a debt of gratitude to those that have provided a healthier climate for healthcare workers and others.

A number of very worthy individuals were nominated for the 2003 International Sharps Injury Prevention Awards. Nominations for this year's awards were submitted by healthcare workers and then reviewed by a nominating committee, comprised of representatives from Managing Infection Control, Tyco Kendall, Becton Dickinson, B. Braun, Deltec, the Association of Needle-free Injection Manufacturers (ANFIM) and the International Sharps Injury Prevention Society (ISIPS). [The manufacturers represented here each paid a sponsoring fee that allowed for the purchase of the awards.]

The International Sharps Injury Prevention Award is a prestigious award given to only a few individuals each year. Five deserving individuals have been notified and have accepted their 2003 International Sharps Injury Prevention Awards. ISIPS and Managing Infection Control congratulate and thank these individuals for making a difference in spreading the message of sharps injury prevention to healthcare workers and employers around the globe. This award is one way of saying thank you for reducing the number of healthcare workers and others who are injured by needlestick and other sharps injuries each year.

Introducing the 2003 International Sharps Injury Prevention Awards Winners

Diane Crawford

Kathi Miller

Brian K. Reaux

Susan Taylor

Captain Bruce G. Weniger, M.D.

About the Winners of the 2003 International Sharps Injury Prevention Awards

Diane Crawford

As the Infection Control Nurse/Professional at Central State Hospital in Petersburg, Va., Diane Crawford has been very proactive in providing the hospital staff with information to prevent nosocomial infections and information to promote a safe work place. She stays well informed on current infection control practices, and was attuned to the fact that new and improved sharps devices would help prevent sharps injuries. Therefore, during the latter part of 2000, she contacted vendors and other Infection Control Practitioners to select and test various sharps products before introducing them to the hospital's long-term-care state psychiatric facility.

"Being an Infection Control Professional compels me to always be committed and to be an advocate of the healthcare worker in regards to sharps safety," says Crawford. "This involves upholding safe practices, usage and selection of improved sharps."

Crawford identified the need to establish a Sharps Injury Prevention Task Force composed of facility healthcare workers interested in sharps safety. The task force was formed in 2001 and has proven to be effective in that members evaluate and critique new sharps devices, write articles for the facility's newsletter related to sharps safety and injury prevention, and monitor for the safe use of sharps within their individual units.

According to the nominator, "Diane's determination and perseverance has resulted in the hospital acquiring safer up-to-date sharps devices and enhancement of staff awareness that sharps safety is worthwhile."

Additionally, there has been a notable reduction in sharps injuries due to Crawford's efforts. She has conveyed to the healthcare workers that they have an obligation to maintain a safe work environment by handling sharps safely and reporting to her any safety issues/concerns they encounter when handling these devices.

"I believe there are still too many frontline workers who do not see themselves at risk for bloodborne exposures by sharps accidents, until they happen," explains Crawford. "My goal is to dispel this myth through sharps safety awareness education."

"Diana has shown exemplary efforts and results in promoting sharps safety among the staff. I admire and respect her expertise and dedication to promoting sharps safety," concludes her nominator's comments.

"I feel very humbled to be acknowledged for such a noteworthy award," says Crawford. "It is often misunderstood that because a job is done or enjoyable, it is easy or uncomplicated. The award recognizes the importance and efforts that it takes to formulate and maintain an effective sharps safety program."

Susan Taylor

According to the nominator, "Susan Taylor is the epitome of what Infection Control Nurses should hope to emulate. She always includes her frontline in the decision-making process and ensures they are the ones who feel safe with the product they are using. She always is willing to evaluate the staff has the best product for clnical use. She is very deserving of this award."

Susan Taylor, MT (ASCP), MS, CIC, is a clinical microbiologist who entered the Infection Control field in 1998 and is currently the Director of Infection Control at St. Dominic Hospital, Jackson, Miss.

In November 1999, Taylor was assigned the job of responding to the OSHA directive on safer sharps devices in the workplace. A multidisciplinary task group was organized to look at where the task group could start reducing sharps exposures. In time, the group became an ongoing committee that was named the Sharp Safety Action Group. High-risk sharps exposures were targeted.

In early 2000, a conversion to a different sharps container with a safety top to preventing overfilling was made. In June 2000, a safety angiocatheter was evaluated and implemented. Sharp exposures from IV catheters decreased by 83% from 2000 though 2001. Beginning in August 2000, a Remedial Training Program was developed for employees who had incurred a sharps injury as the result of carelessness or failure to use safety mechanisms. One year later, a safety needle for IM and SQ injections were evaluated, selected and implemented…resulting in a 44% decrease in this type sharp exposure was noted for 2002.

Two years ago, St. Dominic Hospital received the Portex Innovative Sharps Idea Award for its remedial sharps education program. The recognition encouraged the team to continue its mission of safety. In June 2002, the hospital hosted the Sharps Safari, an educational fair inviting vendors of different sharp safety devices to exhibit safe sharps devices; it also included games and prizes for employees. The theme for the event was centered around an African safari, with hats, animal sounds and animal pictures.

Sharps Safety Education at the hospital has doubled in contact hours in 2001 compared to 2000 continues to pick up momentum: Suture-related sharp exposures decreased in 2002 by 33%; from 1999 to 2002, total sharp exposures were reduced by 40%; many other safety sharp devices have been evaluated and introduced during this time and continue to evolve.

"There are still areas that need work and improvement," says award winner Taylor. "For myself, being in the leadership role of the Sharps Action Group has been a lot of work, but it has also been rewarding to be able to see a reduction in sharp exposure to our employees."

Kathy Miller

Kathy Miller, Infection Control Specialist at HealthEast St. John's Hospital, Roseville, Minn., serves as the co-chair of the HealthEast Needle Safe Committee that was formed in 1999. The incidence of sharps injuries continued to remain at high levels for a number of years from 1996-1999 despite the implementation of some needle safety products; however, there was not a systematic process in place to address this important healthcare safety issue. Miller developed this multidisciplinary Needle Safe Committee to include representation from HealthEast's acute care hospitals, long-term acute care rehab hospital, ambulatory care clinics, surgery centers, home care, hospice and transportation/ambulance division.

After organizing the team, Miller worked with its members to develop a mission: to effectively reduce occupationally acquired sharps injuries through use of safety devices, safer work practices and education using a comprehensive, systematic process for improvement. The committee also created a vision: to develop a culture where prevention of sharps injuries is a work habit and an organizational commitment. The goal is zero sharps injuries.

The Needle Safe Committee is partnered with the HealthEast infection control committee, the Value Analysis Implementation Committee and the local/site-based safety/environment of care committees for support and input. A campaign logo and theme were developed: The Goal is Zero: Zero-In on Accidental Needlesticks! Campaign for Worker Safety Through Sharps Injury Prevention. Miller secured a vendor to support the logo design and to provide posters, stickers and other materials.

An eight-stage model described by John P. Kotter in Leading Change (1996) was used in the process: 1. establishing a sense of urgency; 2. creating a guiding coalition; 3. developing a vision and strategy; 4 communicating the change vision; 5. empowering employees for broad-based action; 6. generating short-term wins; 7. consolidating gains and producing more change; and 8. anchoring new approaches in the culture. In addition, Miller developed a newsletter, Nix the Sticks! as a primary communication tool with updates and articles about needle safety information.

Initial targeted interventions by the needles safe committee and the infection control committee included implementation of new safety devices for IV access, implanted port access and syringes/needles for injection. Initial interventions began in 2000 and following the first year for the three targeted areas a 284% injury reduction overall occurred. From 2000/2001 to 2002 the overall HealthEast rate of injury decreased almost in half from a rate of 0.60 to 0.34. Most injuries occur in the three acute care hospitals and all experienced a decreased rate of injury (0.7 to 0.4, 0.6 to 0.46, and 0.9 to 0.4).

This success was due to Miller's combined approach of implementing safety devices, providing ongoing educational support and assessing work practices. Every opportunity to continue to keep the awareness level high regarding preventing sharps injuries has been utilized. Also, an important part of the culture transformation is that non-safety needles and sharps are being eliminated where clinically feasible. Miller developed an exemption form process for those departments requesting a non-safety device where a safer alternative has been identified. Purchasing serves as a stopgap to prevent departments from ordering non-safety products without review and approval of the needle safe committee. The Exposure Control Plan was revised to include a pictorial guide to needle/sharps safety products available at HealthEast.

In 2003, an additional area of focus is surgery where approximately 25% of reported hospital injuries have occurred. An emphasis has been placed on safe passing of sharps during surgery, injury data is posted over the scrub sinks, and the surgery medical director has been engaged in the process to serve as an advocate.

"Kathy has shown great leadership and endurance throughout this process. She serves as a charismatic and creative advocate for transforming the hospital's work culture to one where sharps injury prevention and worker safety are becoming a habit," reads her nominating letter. This work was presented as a performance improvement initiative during recent JCAHO surveys and has been selected to be presented formally at the APIC-Minnesota Conference.

"I am very honored to be receiving this award, but I'm not the only one who deserves to accept it, because I've got a great team, and so I want to share this award with all of them," says Miller. "I am very committed to this cause. We are truly working toward this goal of Zero! but it is still a rough road to getting there. Our big challenge is in surgery and that is what we are working on right now. That will be the next chapter and I hope it will be as successful!"

Brian K. Reaux

With more than 20 years of experience as a certified orthopedic technician, currently employed at the North Texas Veterans Medical Center, Dallas, Brian Reaux has earned a reputation for his hands-on approach to problem solving.

One of his nominators sent an impassioned plea that Reaux be granted credit…because, according to her, credit was long overdo. "I have worked in the operating room for 23 years and have suffered many needlesticks and sharps injuries throughout the years," writes the registered nurse. "Although there has been some improvement over the years for needlestick preventions, little has been done to protect us from scalpel injuries.

"Mr. Reaux scrubs and assists orthopedic surgeons in a very busy operating room where many sharps injuries occur on a regular basis," the nominator continues. "He has taken a special interest in the safety of the healthcare workers here at the VA and continues to look for ways to provide a safer standard of care for the at-risk workers."

One day about a year ago, the nominator recalls a surgeon passing an eleven blade back to the mayo stand, but instead, the blade sliced the palm of her hand. The ensuing months were difficult for the nurse, who was put on an immediate program of prophylaxis drugs.

"It was at that time that Mr. Reaux decided that something had to be done about the way scalpels were passed in the operating room in order to prevent such an incident from occurring again."

"My commitment is to the continued development of ideas that are practical, user friendly and facilitate a safer environment for healthcare workers and those we serve," says award-winner Reaux.

After months of research and collaboration with healthcare workers, Reaux developed the Scalpel Caddy. The Scalpel Caddy was designed to eliminate the transfer of sharps and thus reduce and/or eliminate the incidents of sharps related injuries in the operating room. The product facilitates OSHA compliance for Needle Stick Injury Prevention and has attracted a lot of attention for it’s practical application and simple features. The product is scheduled for release to market mid-November 2003. The former military medical technician currently has three medical patents in progress including the Scalpel Caddy.

"Mr. Reaux has shown strong leadership in preventing sharps injuries and is regarded as a model collaborator with his colleagues," says his nominator. "He has demonstrated creative, consistent contributions to the field of preventing sharps injuries."

"I am profoundly happy for the recognition, especially for my fellow healthcare colleagues, who will be made more aware of the device and safety features it offers," says Reaux. "This recognition is resounding confirmation of the support and concern for safety in the healthcare arena."

As for his goals for the future, Reaux is succinct: "I hope to continue the charge to make the provision of healthcare a safer profession for my fellow colleagues and the patients we serve."

Captain Bruce Weniger, M.D.

Dr. Bruce G. Weniger is the Assistant Chief of Vaccine Development in the Immunization Safety Branch, National Immunization Program, at the Centers for Disease Control and Prevention (CDC) in Atlanta, as well as adjunct Associate Professor in the Emory University School of Public Health. He was nominated in recognition for providing scientific leadership in facilitating the development of safer methods and technologies for the administration of vaccines. Through his efforts, needle-free jet injection technologies are both routine clinic use and mass campaigns are being developed with support from the CDC.

Weniger has been instrumental in assembling the vaccine and getting the immunization community to recognize the dangers of conventional needles and potential risk of bloodborne disease transmission from traditional jet injectors with reusable nozzles, and in promoting the development of safer, needle-free devices with disposable cartridges. He has been active in the promotion of needle-free injection technology for many years: During 1997 to 1999, he spearheaded an international initiative to promote a new generation of safe, needle-free jet injectors for vaccination.

"One complementary goal we are pursuing is to work toward a common international standard for jet injector cartridges," Weniger explains, "so that pharmaeceutical manufacturers can prefill them ready for injection (instead of using vials as the primary packaging, requiring manual transfer by the health provider), and device manufacturers can develop a range of compatible injectors for various uses in hospitals and clinics, or in mass campaigns, for both the developed and developing world.

Weniger organized the first and second international conferences on needle-free injection, and he regularly disseminates information about the field through published articles, Internet mailing lists, websites, and public presentations before scientific meetings, the press and the FDA. He has consulted for several international agencies on various missions, and served on the WHO Global Programme on Vaccines and Immunization's Steering Group on the Development of Jet Injection for Innunization in 1997.

"Public health and clinical care communities in recent years have increasingly recognized the dangers and drawbacks of using needle and syringe to administer vaccines and other medications," he says. "Alternatives are unlikely ever to completely replace needles for use in venipuncture, surgical procedures, and other specialized indications. But the biotechnology revolution is offering an increasing number of needle-free methods to deliver drugs safely, effectively, and often painlessly.

"Work is underway on oral medications which protect their active ingredients from the damaging effect of stomach acid which has heretofore ruled out this route," Weniger continues. "Tablets that dissolve instantly and avoid even the need to swallow are already on the market. Some prescription medications that used to require needles can now be administered by nasal spray. Medications such as insulin and measles vaccine are being studied for pulmonary inhalation. The skin and its dendritic/Langerhans cells are now recognized as an important part of the immune system and a promising site for convenient, painless vaccination."

Author bio:

Ron Stoker, a frequent contributor to Managing Infection Control magazine, is the Executive Director of ISIPS, the International Sharps Injury Prevention Society. He is a frequent speaker on sharps safety and occupational blood exposure at national and international events. For more information about ISIPS and sharps safety products, visit www.isips.org, or email Mr. Stoker at ron@isips.org.