Sharps Injury Prevention in the Pediatric Perioperative Setting

 Acute care hospitals have among the highest occupational injury & illness (OII) rates of all industries.  Exposure to contaminated sharps devices is often the largest proportion of hospital incident types. Pediatric hospitals are a specialized sub-sector that may present particular prevention challenges that have not been commonly evaluated in the literature.

The Environmental Health & Safety (EH&S) department of a U.S. pediatric academic teaching hospital initiated a perioperative sharps injury prevention project in November of 2013. Sponsored by the Chief Surgeon, a multidisciplinary team of clinical and support services staff was recruited to participate. Process mapping, risk perception and reporting survey, joint incident investigations, device handling audits, and research of safety devices and best practices were employed. Project goals were to assess the culture of sharps incident reporting, increase participation in health & safety by staff and leaders, identify prevention opportunities and reduce incidence rates by 5% in 12 months.

Meeting minutes indicate sustained staff participation at 90%. The culture of reporting was found to need improvement as indicated by only 60% of perioperative staff responding that they reported sharps incidents 100% of the time. Investigations, observations and audits revealed opportunities for prevention through improved passing, safety device use by senior physicians, better hand-offs to central processing, and better management of disposable devices after use. After 1 year, incidence rates were flat or slightly increased.

Multidisciplinary sharps safety working groups can improve staff health & safety participation and awareness when coupled with senior leadership sponsorship in pediatric teaching hospitals.