In 2000, OSHA implemented the
Needlestick Safety and Prevention Act (NSPA). NSPA is strongly enforced today and
OSHA continues to require engineering and work-practice controls to effectively
manage and/or minimize employee exposure.
For years, workplace safety programs
in healthcare organizations have emphasized protecting healthcare workers from
slips, falls and sharp objects. Although needlestick injuries, slips and falls
get the most attention, non-sharps exposure poses a risk to healthcare workers
as well. Splashes are another potential threat facing healthcare workers, says
Jacie Volkman, board member for the Association for Professionals in Infection
Control (APIC) and owner of Safe Patient Surveys Inc., an infection prevention
consulting company. According to Volkman, many healthcare organizations fail to
address splash exposures, putting caregivers at risk of developing potentially fatal
diseases.
Nurses and providers may contract
infections such as hepatitis B, hepatitis C, HIV and other pathogens from preforming
daily activities. Splashes to the eyes, nose or mouth from emptying suction
cups, washing bedpans, cleaning urine bottles or cutting open catheter bags
poses a significant occupational hazard. A 2003 study revealed that more than
more than one-third (39%) of registered nurses and one-fourth (27%) of licensed
practical nurses experienced at least one of these types of mucocutaneous
blood exposure in the previous 3 months.
The frequency of these types of exposures not only puts
healthcare workers at risk, but it also desensitizes
them to the danger and the need to take proper precautions.
“We’ve breed a culture of
desensitization,” says Tom Jedowski, marketing manager at MEIKO USA Inc. “Workers would freak out if it was a pan full of blood, but because its
something else people just pass it off as being part of the drudgery of care.”
The same study found that only about
73% of these splashes were reported. According to Volkman, many healthcare workers
have accepted that splashes are an unavoidable part of the job, but another
issue may have more to do with the time and cost that go into reporting an
incident. Reporting a splash can be considered a hassle, she says. After an employee reports the incident, the worker and the patient must receive several tests, costing the hospital time and money, and if infections are found, a
round of treatment is needed, costing even more time and money.
Even excluding the personally and emotional
ramifications of exposure, many factors must be considered, says
Volkman. Lost time, cost of exposure panels for both the patient and employee
and any resulting healthcare costs are all burdens on the system.
To decrease splash exposures in a healthcare
setting, which will in turn decrease organizational costs, a shift
in culture is needed, says Volkman. Hospitals must change their safety culture. Senior
leadership must endorse measures that will lead to a safer environment, which
includes changes in systems, PPE and employee education.
- Systems: Currently, many hospitals use a commode spray to clean urinals, bedpans or suction canisters, creating a severe risk of splash back, says Jedowski. Disinfection appliances, such as bedpan washers, can decrease the risk of splashes by eliminating the need to empty these devices into a toilet or hopper.
- PPE: According to Volkman, PPE must be available everywhere. Having PPE readily available helps employees remember to wear it at all times. Many organizations use cabinet-type dispensers to display equipment to make it more apparent when the stock is low. Volkman also suggests using face masks with attached eye shields to help workers limit eye exposures as long as they are already protecting their nose and mouth.
- Education: Whenever there is a change in practice, education is imperative. Compliance should be monitored as well as issues with any particular device or PPE.
Workplace
safety programs have been successful in reducing injuries from slips, falls and
sharp objects. With these changes, splashes risks can be reduced as well.
“There is no magic bullet,” Volkman says, noting that it is up to individual organizations
to understand the hazards in their facilities and design a program and
environment to effectively manage these hazards to keep their workers safe.
