Needlestick Prevention Devices

Many staff members in aging services organizations are at risk of exposure to bloodborne pathogens from needlestick and other sharps injuries. These injuries occur not only to nurses, nursing aides, and other medical caregivers but also to personnel working in housekeeping and laundry services and to family caregivers and home health aides. Likewise, as skilled nursing facilities and subacute care units perform more intravenous (IV) and other invasive therapies, the risk to personnel in these settings can also be expected to increase. Annually, almost one in five healthcare workers experiences a needlestick injury—more than 800,000 instances per year (Premier Safety Institute).

The Occupational Safety and Health Administration’s (OSHA) bloodborne pathogens standard requires employers with any employees who have occupational exposure to bloodborne pathogens—defined as reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties—to annually document consideration and implementation of safer medical devices designed to eliminate or minimize occupational exposure. The standard also requires employers to have in writing an exposure control plan, implement standard precautions, provide personal protective equipment, implement best practices (e.g., no recapping needles, disposing of sharps immediately after use), make hepatitis B vaccination available (unless the employee has already been vaccinated, is immune, or has medical contraindications), maintain a sharps injury log, and provide evaluation and follow-up care after an injury. (Premier Safety Institute) For more information, see the Risk Analysis OSHA's Bloodborne Pathogens Standard.

One of the most common routes for bloodborne pathogen exposure is through injuries caused by blood-filled, hollow-bore needles. Such needlestick injuries can result in exposure to HIV, the hepatitis B and C viruses, or other pathogens. Therefore, a principal component of many sharps injury prevention programs is the use of devices that help reduce the number of needlesticks: needlestick prevention devices (NPDs), referred to in OSHA’s bloodborne pathogens standard as “devices with engineered sharps injury protection.” Once engaged, NPDs physically shield the sharp, helping to protect residents and staff against needlesticks and other sharps injuries.

Most NPD designs require some specific user action to engage the safety feature—for instance, some require pushing a button, while others may require sliding a protective mechanism over the sharp, though a few passive designs are available. Users must be trained to know how each NPD is activated to ensure proper performance. Since some staff members may use a variety of NPDs daily,...