Post Category → Healthcare workers

1/2 Day seminar – Preventing Sharps Injuries

I’ve exciting news!

A major player has agreed to sponsor a 6-city Sharps Injury Seminar in US and Canada.

SI have not decreased as expected. The impact of safety engineered devices (SED) has plateaued and HCW are asking what more can they do?

Myself and two other passionate experts are determined to put SI back on the radar with 3 educational outcomes covering:

  1. Incidence and trends
  2. Impact on HCW
  3. Successful prevention strategies

The seminar is CEU accredited and will be held in Philadelphia, Chicago, Orlando, Montreal, Vancouver and Toronto.

Sponsorship has enabled a very low fee. Click here for your city and more details

Sharps Injuries among Australian Healthcare Workers

Sharps Injuries are far too frequent among Australian healthcare workers (HWC)

Accidental sharps injuries (SI) via needles, sutures, etc, all carry a small but real risk of transmitting bloodborne diseases like HepB, HIV, etc., to the injured HCW.

In fact, Tarantola et al state there are 60 infectious diseases that can be transmitted by these injuries.

At the Australasian College of Infection Prevention and Control (ACIPC) 2016 conference, myself, Nicole Vaust and Jane Parker presented the results of a national survey we conducted among ACIPC members (with ACIPC and Ethics approval)

We asked members 9 questions on their institution’s 2014 occurrence of SI and mucocutaneous exposures (blood splashes to face, etc) – 307 hospitals from 6 states participated, making the survey one of largest in Australia – and we were surprised at the results.

Three out of every hundred HCW reported a sharps injury in 2014 (higher than USA rate); 51% of reported SI were nurses and 37% doctors; and 47% of all SI occurred during surgical procedures.

Extrapolating to Australia nationally, this means over 30,000 HCW sustain an SI annually – 80 per day!

Could it be that Australian HCW are not using safety engineered devices often enough? Or correctly?

What is clear is that this issue needs greater attention at state, perhaps federal legislative level – as it has in most developed countries.

click here for our poster

We will shortly submit our manuscript to the ACIPC Journal of Infection, Disease and Health – so watch this space.

EXPO-STOP 2015 Blood-exposure Survey – Sneak Preview

AOHP EXPO-STOP blood-exposure survey is too large for one post – but here’s a sneak preview

The 2015 EXPO-STOP blood exposure survey of the Association of Occupational Health Professionals in Healthcare (AOHP) will take several publications to convey all the data to readers – so Linda Good and I wanted to share the presentation we delivered at the Sept 2016 AOHP Conference in Myrtle Beach SC, USA.

In this 5th annual EXPO-STOP survey, 182 hospitals from 38 states participated  – making it USA’s largest.

The PowerPoint covers: the 2015 EXPO-STOP national blood exposure incidence; proven strategies to reduce sharps injury (SI) incidence; and url’s of many resources

Take Home Messages …

  • USA SI incidence is 2.1 per 100 FTE hospital staff – a significant decrease from 2.7 in 2001
  • Nurses at 3.2 SI/100 FTE represent 46% of all reported SI (Drs 32%)
  • Surgical SI = 38% of all SI reported
  • But… this incidence means 320,000 HCW sustain SI annually – almost 1,000/day.
  • Renewed focus on prevention strategies is needed
  • Best practices include more effective Safety Devices, Competency training, Communication to all, Investigation, Engagement – particularly in OR.

Click here for download of PPT presentation

Watch this Space! – the top proven SI prevention strategies will be published in JAOHP Winter Issue in March 2017

AOHP’s latest 2013 & 2014 Blood Exposure Study

The USA Association of Occupational Health Professionals in Healthcare (AOHP) has issued a press release on the publication of their 2013-14 survey of Blood exposure incidence among US healthcare workers (HCW).

The survey, AOHP’s third in their annual series, and in which 84 hospitals in 28 states participated in supplying their 2013 and 2014 data, shows a significant rise in exposure incidents among US HCW.

Using “per 100 occupied beds” as the denominator, the 2014 sharps injury (SI) rate of 33.3, is significantly higher than the 24.0 in AOHP’s 2011 survey, and significantly higher than the EPINet rate of 22.2 in 2001, the year safety engineered devices (SED) became mandatory.
Exposure incidents include the HCW being stuck with a blood-contaminated needle or having a patient’s blood or blood-contaminated fluids splashed onto them. Each such incident carries a small but definite risk of transmitting one or more of 60 diseases, the three most well-known being HIV, Hepatitis C and Hepatitis B.

The denominator showing the highest rise was “Occupied beds” and this may reflect  the inability of this denominator to reflect the increases in day-patients and outpatients. However, “Total FTE”, a mirror of total patient workload, also showed a rising trend.

The paper, authored by Carol Brown, Miranda Dally, myself and Linda Good, propose the rise may be due to:

  • increasing HCW workloads;
  • decreasing resources;
  • increasing day-patient and outpatient numbers, and
  • incorrect use of SED

Several hospitals stood out for their low exposure rates. Examples of their successful reduction-strategies were: Competency-based education at orientation and annually (and repeated with all injured HCW); Investigation of every sharps injury; Making SI rates transparent and known to all staff; Requiring a waiver to be requested for non-SED use; Holding HCW and Management responsible for their safety.

The published copyright paper may be purchased by emailing AOHP at info@aohp.org.  A complimentary, pre-publication Author Copy , for personal use only, is available here.

AOHP’s fifth annual survey (2015 calendar year) is in progress with publication aim late 2016.

Zika: update on geography, precautions and sexual transmission

Last Friday I stated Zika was in theory capable of sexual spread, and on Tues Feb 2nd, the Texas Dept State Health Services confirmed a sexually transmitted case.

Prior to the Texas announcement only one sexually transmitted case had been confirmed – Foy et al in 2011 published a case in the wife of a Zika researcher returning to Colorado in 2008. Subsequently, Musso et al in 2013 found Zika in the semen of an infected Tahitian male.

Notwithstanding the above, CDC confirm transmission is primarily via mosquitoes (Aedes – they also transmit dengue, but not malaria), and rarely, to the foetus from infected mothers.

Zika is a mild disease, predominantly with no symptoms, but with 4,800 cases of microcephaly in Brazilian babies in the last 18 months, this aspect, and the rapidity of spread of the disease (up to 1.4 million cases in Brazil in 2015) caused WHO on Monday to classify ZIKA as a Public Health Emergency of International Concern (PHEIC).

By classifying Zika as a PHEIC, WHO mobilizes internationally the resources for research and action into the disease, its sequelae, and its prevention.

WHO state there should not be travel or trade restrictions with any Zika-active country and CDC state prevention is via classic anti-mosquito measures and have issued cautionary travel advice for pregnant females

The US has the relevant Zika Aedes species in the lower states and as yet mosquito-transmission has not been documented but, with returning travelers, there is the possibility of local Zika transmission

But if Zika was first discovered in Uganda monkeys in 1947 (first human case in 1952), then appeared in the Pacific in 2007 with the first major epidemic being in French Polynesia in 2013, how did it suddenly explode in Brazil? It was not the Brazil World Cup as originally thought. Musso examined the “fingerprint” of Zika isolates in infected countries and determined that during 2013-14:

  • The origin of introduction to French Polynesia is unknown
  • New Caledonia was infected from infected travelers returning from French Polynesia
  • French Polynesians brought the virus to Easter Island when attending the island’s Tapati Festival in early 2014
  • Other nearby Pacific countries were infected because inter-travel is common
  • In Aug 2014, teams from several of the above Pacific countries attended the World Canoe Championships in Rio de Janeiro. Musso suggests this introduced Zika to Brazil.

Now, in just 18 months, 28 countries have active Zika transmission.

Fortunately for New Zealand (where I live) the Ministry of Health state the subspecies of Aedes has not been found. But returning travelers with symptoms might need heed the Texas news. And spread via an accidental needlestick to an attending healthcare worker, although as yet undocumented, must also be a concern.

What patients wish for in hospitals

Let me sleep, and Oh, please knock on my door when entering.

Becker’s Hospital Review alerted me to the work of Peter Pronovost of  The Johns Hopkins. He recently reviewed patient surveys and with Jane Hill compiled the top ten wishes of hospital inpatients.

  1. Let me sleep. Do not take vitals throughout the night or draw blood between 10 p.m. and 6 a.m. unless it is critical. If it is critical, please make sure I understand. My sleep helps me recover and feel better.
  2. Keep the noise levels down at the nurses’ station. This is so important – especially at night when my sleep is needed. Turn off the TV, radio, computer screen, etc., at night in my room, so there’s not a glare or noise that can disturb my sleep.
  3. Don’t lose my personal belongings. Take an inventory and label everything with my name and medical record numberso my personal belongings do not get misplaced. These belongings are an extension of me and make me feel more at ease. Taking care of my stuff feels like you are taking care of me.
  4. Knock on the door before entering. This shows respect for me as an individual and my privacy. Introduce yourself to me, and shake hands or make eye contact when you do this. Call me by my preferred name (formal or first name).
  5. Please keep my white board current and up to date. It gives me a quick reference of who is caring for me and my daily plan. Provide a notebook at the bedside so I can keep all my important papers, cards from my health care team and other staff, etc. in one place. Please make sure my name and my location (nursing unit, room number and room phone) are listed on the front.
  6. Update me and my family if you notice changes in my condition. Keep communication open. Please keep me informed of delays. It lessens my anxiety during an already stressful time.
  7. Keep my room clean – mop the floors every day, wipe surfaces to prevent the spread of germs, empty my wastebasket and keep my bathroom really clean so it even smells clean. If you are my housekeeper, please introduce yourself to me and say hello. I like to know who is taking care of me.
  8. Listen to me and engage me in my care. Use plain language, and make sure I understand my plan of care.
  9. Please orient me to my room and the hospital, so I know where important things are located, how to work the television, how to order food and when my linens may be changed. I am a guest here and don’t know these things, yet these are important to me.
  10. Please maintain professionalism in ALL areas of the hospital. While you may be on your break, you are still a hospital employee and a reflection of the hospital. How I perceive you is often how I perceive the hospital and care that I am receiving.

The original article was published by US News & World Report – Health.