Sharps Injuries in the Operating Room Amanda M. Gust, MPH Amanda M. Gust, MPH Raymond C. Sinclair, PhD Raymond C. Sinclair, PhD Pat Hickey, RN, BSN, MS, CNOR Pat Hickey, RN, BSN, MS, CNOR Alice Weiss, RN Alice Weiss, RN Carmen Garcia, RN Carmen Garcia, RN National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Centers for Disease Control and Prevention August 1, 2002 August 1, 2002
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Sharps Injuries in the Operating Room Amanda M. Gust, MPH Raymond C. Sinclair, PhD Pat Hickey, RN, BSN, MS, CNOR Alice Weiss, RN Carmen Garcia, RN National.
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Campaign ProcessCampaign Process Communications campaign are sustainedCommunications campaign are sustained
““Can campaign methods be used to effectively Can campaign methods be used to effectively prevent occupational sharps injuries?” prevent occupational sharps injuries?”
Stop Sticks Campaign
Columbia, SC—5-year pilot projectColumbia, SC—5-year pilot project Goal: Goal:
Raise awareness among health care workers regarding Raise awareness among health care workers regarding exposure to BBPs from sharps injuriesexposure to BBPs from sharps injuries
Clinical HCWsClinical HCWs Non-clinical HCWsNon-clinical HCWs Health care administratorsHealth care administrators
Six (6) primary facilitiesSix (6) primary facilities
Stop Sticks Campaign
Aims to deliver information and educationAims to deliver information and education BBPs, exposure prevention methods, device BBPs, exposure prevention methods, device
trainings, website, trainings, website, PSAs, direct mail, exhibits, PSAs, direct mail, exhibits, safety fairs, mini-campaignssafety fairs, mini-campaigns
OR Safety Blitz
February 2002February 2002 1 month long1 month long
Largest community hospitalLargest community hospital 24 operating rooms24 operating rooms ~150 OR staff~150 OR staff
OR has highest rate of sharps injuryOR has highest rate of sharps injury Reduce injuries by going “back to the basics”Reduce injuries by going “back to the basics”
Campaign Process
AudienceAudience
AudienceAnalysis
MessageDevelopment
MessageDelivery Evaluation
1 2 3 4
Campaign Process
Audience AnalysisAudience Analysis The more you know the betterThe more you know the better
EducationEducation – – 2-15 years of additional schooling 2-15 years of additional schooling
Attitudes about safety – Attitudes about safety – various stages (Ex: Neutral Zone)various stages (Ex: Neutral Zone)
Environment – Environment – Fit campaign into current working conditionsFit campaign into current working conditions
Messages kept fairly non-technical with a few exceptionsMessages kept fairly non-technical with a few exceptions
Ex: surgical grand roundsEx: surgical grand rounds
Campaign Process
Message DevelopmentMessage Development Relative risk, prevention strategies, & treatment optionsRelative risk, prevention strategies, & treatment options Content should lead to increased knowledgeContent should lead to increased knowledge Clear / simple messages with frequent repetitionClear / simple messages with frequent repetition Develop messages simultaneouslyDevelop messages simultaneously
Avoid contradictionAvoid contradiction Creative & appealing Creative & appealing Pilot draft messages before usePilot draft messages before use
Campaign Process
AudienceAudience
MessageDevelopment
MessageDelivery Evaluation
1 2 3 4
Audience Analysis
OR Safety Blitz
Message DevelopmentMessage DevelopmentOne message per weekOne message per week
1.1. Risk of experiencing a sharps injuryRisk of experiencing a sharps injury
2.2. Passing and loading cause the most sharps injuriesPassing and loading cause the most sharps injuries
3.3. Establish a neutral zoneEstablish a neutral zone
4.4. Use safer sharps devicesUse safer sharps devices
Balance between “reviewing old” information and Balance between “reviewing old” information and “providing new” information to capture attention“providing new” information to capture attention
Campaign Process
Message DeliveryMessage Delivery Set a strategic schedule for disseminationSet a strategic schedule for dissemination
Coordinate message releaseCoordinate message release• Ex: risk of sharps injuries Ex: risk of sharps injuries info. about safer info. about safer
sharps devicessharps devices device evaluation device evaluation Method of delivery & number of repetitionsMethod of delivery & number of repetitions
Use several channelsUse several channels• Numerous choicesNumerous choices• Strengths & weaknesses varyStrengths & weaknesses vary
RepetitionRepetition
OR Safety Blitz
Message DeliveryMessage Delivery Use pre-existing channels if appropriate Use pre-existing channels if appropriate (we had several)(we had several)
Six (6) channels of communicationSix (6) channels of communication Posters (over the scrub sinks)Posters (over the scrub sinks) Newsletter articlesNewsletter articles Mandatory bi-monthly staff meetings Mandatory bi-monthly staff meetings Paycheck stufferPaycheck stuffer Device fair exhibitDevice fair exhibit Promotional itemsPromotional items
• Available resources, what questions you want Available resources, what questions you want answered, existing opportunitiesanswered, existing opportunities
OR Safety Blitz
EvaluationEvaluation Pre-test given during week 1 – (n = 90 / 150)Pre-test given during week 1 – (n = 90 / 150) Post-test 1 month after completion of blitz – (n = 37 / 150)Post-test 1 month after completion of blitz – (n = 37 / 150) General make-up between pre / post-test comparableGeneral make-up between pre / post-test comparable Q = During my time of employment in the OR, I have experienced a Q = During my time of employment in the OR, I have experienced a
sharps injury:sharps injury: Never = 35%Never = 35% 1-3 times = 49%1-3 times = 49% More than 3 times = 9%More than 3 times = 9% No answer = 7%No answer = 7%
Respondents valued all 4 methods of reducing sharps injuriesRespondents valued all 4 methods of reducing sharps injuries Safer techniques, neutral zone, improved communications, Safer techniques, neutral zone, improved communications,
More physician involvement – More physician involvement – esp. anesthesiaesp. anesthesia
• Include residents and studentsInclude residents and students Implement what we have learnedImplement what we have learned
Increased campaign impact?Increased campaign impact? Speaker with a negative outcomeSpeaker with a negative outcome More staff inputMore staff input
Next steps:Next steps: Follow-up & continued emphasis of safety practicesFollow-up & continued emphasis of safety practices Implementation of safety techniques & deviceImplementation of safety techniques & device
OR Safety Blitz
Lessons LearnedLessons Learned Importance of close communicationImportance of close communication
Posters and newsletter articlesPosters and newsletter articles Paycheck stufferPaycheck stuffer EvaluationEvaluation
Campaigns may work in OSH Campaigns may work in OSH Only positive feedback – Only positive feedback – “we want more”“we want more”
Content added to residency orientationContent added to residency orientation Blitz approach used for JCAHO activitiesBlitz approach used for JCAHO activities
Conclusion
OR Safety Blitz vs Stop Sticks CampaignOR Safety Blitz vs Stop Sticks Campaign Department, Facility, or Community levelDepartment, Facility, or Community level
Still contains all four (4) processesStill contains all four (4) processes• Study your audience – Study your audience – check back at each stagecheck back at each stage
• Use multiple messages – Use multiple messages – stay consistentstay consistent
• Use multiple channels – Use multiple channels – repetitionrepetition
• Evaluate your effortsEvaluate your efforts Systematic approach when doing communicationsSystematic approach when doing communications
Contact Information
National Institute for Occupational Safety & HealthNational Institute for Occupational Safety & Health (800) 35 - NIOSH(800) 35 - NIOSH