1. Needlestick Injury Reduction Lisa E. Woody, MD, MPH Debbie Janca, RN, COHN-S

2. Opportunity Statement Injuries from needles used in healthcare and laboratory settings may result in transmission of bloodborne pathogens to healthcare workers. The goal of this project is to reduce the anxiety, expense and lost productivity associated with these injuries by reducing needlesticks by 50%.

3. Most Likely Causes  Failure to use safety engineered needles  Unsafe work practices (recapping, removal of phlebotomy tube holder)  Failure to dispose properly  Disposal system failures (overfull containers, needles sticking out of containers or piercing sides)

4. Solutions Implemented  Exposure Prevention Committee (EPC)established by the Infection Control Committee  Representatives from clinical nursing units, Risk Management, Nursing Education, Clinical Nutrition and Occupational Health Services  EPC representation on Clinical Products Committee  Introduction of safety-engineered needle devices and needleless procedures

5. BD Eclipse Hypodermic and PhleBotomy Needles

6. Results – Data Analysis  30% reduction in hollow bore needle injuries following introduction of safety- engineered hypodermic and phlebotomy needles in June 2003  Special cause variation identified after introduction and training complete

7. Occupational Health Services Hollow Bore Needle Exposures July 04 Temporary: UCL=16.74, Mean=8.24, LCL=-0.26 (not shown) (mR=2) Jun - 99 Sept - 99 Dec - 99 Mar - 00 Jun - 00 Sept - 00 Dec - 00 Marc - 01 Jun - 01 Sept - 01 Dec - 01 Mar - 02 Jun - 02 Sept - 02 Dec - 02 Mar - 03 Jun - 03 Sept - 03 Dec - 03 Mar - 04 June - 04 July - 04 4 6 8 10 12 14 16 UCL Mean July 04Temporary: UCL=16.74, Mean=8.24, LCL = - 0.26 (not shown) Jun - 99 Sept - 99 Dec - 99 Mar - 00 Jun - 00 Sept - 00 Dec - 00 Marc - 01 Jun - 01 Sept - 01 Dec - 01 Mar - 02 Jun - 02 Sept - 02 Dec - 02 Mar - 03 Jun - 03 Sept - 03 Dec - 03 Mar - 04 June - 04 July 04 4 6 8 10 12 14 16 UCL Mean Hollow Bore Needle Exposures

8. Recommendations for Further Study or Action  Review exposures resulting from unsafe work practices to determine root cause and implement safer procedures  Review disposal system for improvement opportunities  Review exposure data for previously implemented devices and replace devices associated with continuing injuries