New OSHA bloodborne pathogens standard clarifies need for employers to select safer needle devices. (Washington Report).
The need for safer sharps is being driven by a number of factors including a push by healthcare workers who are affected by needlesticks in the workplace. Accidental needlesticks pose the greatest threat because bloodborne pathogens are more likely to be transmitted in this way than by injuries from other sharp devices. The testing and treating of employees with needlestick injuries currently runs into the billions.
Newer, safer medical devices can reduce the risk of needlesticks and the chance of contracting deadly bloodborne diseases such as AIDS and the hepatitis C virus. Research from the CDC, for example, indicates that selecting safer medical devices could prevent 62-88% of sharp injuries in hospital settings.
The revised standards are mandated by the Needlestick Safety and Prevention Act, which Congress passed unanimously last year. They were scheduled to go into effect this year on April 18, but the Bush Administration called for a 60-day delay on all regulations that were not in effect on January 20, 2001. As a result, OSHA doesn't have "any specific policy guidance yet as to whether or not these regulations will be allowed to go ahead and take effect or whether there will be a delayed date," says Susan Hall Fleming, an OSHA press spokeperson.
What the new standards require
Under the new standards, employers must select safer needle devices as they become available and involve employees in identifying and selecting the devices. Staff involvement in the selection process can play an important role in the acceptance and proper use of safer medical devices, OSHA says. Labs must document the solicitation of input from employees in their exposure control plan. These plans are required under OSHA's bloodborne pathogen standards. The plan must be reviewed and updated every year to reflect any changes in technology that eliminate or trim exposure to bloodborne pathogens.
The proposed standards do not outline specific procedures that have to be established with regard to input from employees. Instead, employers can solicit input in a way they feel best fits their particular workplace. For example, a large lab might find more formal procedures work best. OSHA suggests that some of the methods that might be used by providers include problem-solving groups; participation in safety audits and worksite inspections; or involvement in a safety and health committee.
In addition, labs must consider safer needle devices as part of the reevaluation of appropriate engineering controls during the annual review of the employer's exposure control plan.
The aim of the engineering controls is to isolate or remove the bloodborne pathogens hazard from the workplace. These include sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections, and needleless systems.
The updated standard also requires employers to maintain a log of needlesticks rather than only recording those cuts or sticks that actually lead to illness. Information in the log must give the name of the device involved if it is known; the location of the incident; and the description of events that resulted in the injury. The standards also require that employers maintain the privacy of employees who have suffered these injuries. The format used for the information can be either electronic or paper.
This new reporting standard is designed to help employers determine the effectiveness of the devices they use and track how many needlesticks are occurring within their workplaces.
To date, laboratories affected by the new rules have not vocalized support or opposition to the rules. Members of the Washington, DC-based American Clinical Laboratory Association, for example, have been fairly silent on the revised standard, says Joanne Glisson, ACLA's vice president of government affairs. In some instances, the higher cost of the safer sharps has been a concern. Another obstacle to users of safety needles is the fact it is sometimes difficult to obtain large numbers of them.
In reviewing the revised standard, Glisson says that it is "not clear what exactly OSHA requires labs to absolutely do." Nevertheless, she expects large laboratories will do what they can to switch to safer needles. "It is the surest way to comply," she adds.
Once OSHA receives word from the Bush Administration on the effective date of the standards, it will publish the date in the Federal Register. OSHA's Fleming says the new standards may still go into effect on April 18 or on a different date.
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|Publication:||Medical Laboratory Observer|
|Date:||Mar 1, 2001|
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