Sharps Injury Data- The problem with
currently available safety scalpels
14 November, 2011

A recent study published by the American College of Surgeons titled, ‘Increase in Sharps Injuries in Sur gical Settings Versus Nonsurgical Settings After Passage of National Needlestick Legislation’ reported the following data relating to sharps injuries:

‘...scalpel blade injuries cannot be prevented by safety scalpels currently available on the market, because these scalpels are loaded with a sharp-tipped blade.’ Of the top three devices that cause sharps injuries, suture needles, scalpels, and disposable syringes , the majority of injuries occur near the beginning of the use-disposal cycle—that is, during use, while passing the device, or between steps of a multi- step procedure. Injuries during these early phases accounted for 83.5% of suture needle injuries, 69.8% of scalpel blade injuries, and 51.9% of injuries from disposable syringes.

These findings are significant because they reveal that scalpel blade injuries cannot be prevented by safety scalpels currently available on the market, because these scalpels are loaded with a sharp-tipped blade.

The focus, so far, has been on the prevention of preventable injures that may occur, for example, during passing with the use of engineering controls such as retractable safety scalpels or retractable shield scalpels. These mechanisms are an attempt to control the risk that a sharp-tipped scalpel blade poses.

SCALPEL INJURY PREVENTION GUIDANCE
ENGINEERING CONTROLS- ROUND TIP SCALPEL BLADES AS A SOLUTION FOR PREVENTING SHARPS INJURIES.
08 November, 2011

The use of engineering controls is an integral part of any Exposure Control Plan.

Blunt-tip suture needles have been identified by OSHA as an example of an engineering control to reduce percutaneous injuries.

CDC has identified round tip scalpel blades as an example of an engineering control to reduce percutaneous injuries. OSHA, NIOSH, and CDC have jointly released a safety and health information bulletin
“Use of Blunt-Tip Suture Needles to Decrease Percutaneous Injuires to Surgical Personnel” presenting evidence of the effectiveness of blunt-tip in decreasing percutaneous injuires and strongly encourage the use of blunt tip suture needles.

Scalpel blades: The CDC and the AORN in their workbook and guidance statement have identified round-tip scalpel blades as an example of an engineering control to reduce percutaneous injuries. The Exposure Prevention and Information Network (EPINET) of the University of Virginia’s International Healthcare Worker Safety Center, in its Checklist for Sharps Injury Prevention asks, “Are scalpel blades with safety features used such as round-tipped scalpel blades…?”

SCALPEL INJURY PREVENTION GUIDANCE
Recommended Practices for Cleaning and Care of Surgical Instruments and Powered
06 November, 2011

As per AORN’s “Recommended Practices for Cleaning and Care of Surgical Instruments and Powered Equipment,” reusable metal scalpel handles should be considered sharp. Considering a reusable scalpel handle to be sharp minimizes the risk of injury, if a blade has been left on the handle. Visually check that the blade has not been left on the handle.

Reusable metal scalpel handles should be considered sharp. Visually check that the blade has not been left on the handle. OSHA’s BBP standard requires that where engineering and work practice controls will reduce employee exposure either by removing, eliminating or isolating the hazard, they must be used. This would include the use of ultrasonic cleaners and washer-disinfector as a form of engineering control.

Work practice controls require reusable sharp to be segregated from other instruments and placed in a separate puncture proof container for transportation until properly reprocessed. AORN recommends establishing a separate area to place a reusable sharp for safe handling during the procedure. CDC and OSHA also recommend the use of long-handled brushes (to keep the hand as far away as possible from sharp instruments) for cleaning reusable sharps, to reduce the potential for employee exposure to blood or other potentially infectious materials.

Employees should wear personal protective equipment according to regulations. Employees should not reach into trays, containers or sinks holding sharp instruments that cannot be seen.