Don’t Get Stuck: A Quality Improvement Project to Reduce Perioperative Blood-Borne Pathogen Exposure

摘要

Background: Blood-borne pathogen exposure (BBPE) represents a significant safety and resource burden, with more than380,000 events reported annually across hospitals in the United States. The perioperative environment is a high-risk areafor BBPE, and efforts to reduce exposures are not well defined. A multidisciplinary group of nurses, surgical technologists, surgeons,and employee health specialists created a BBPE prevention bundle to reduce Occupational Safety and Health Administration(OSHA) recordable cases.Methods: Mandatory double gloving, a safety zone, engineered-sharps injury prevention devices, and clear communicationwhen passing sharps were implemented in an evidence-based fashion at one institution. Days between exposures and totalnumber of exposures were monitored. Analysis by specialty, role, location, type of injury, and timing was performed.Results: During fiscal year (FY) 2015, 45 cases were reported. During the first year of implementation, cases decreased to 38(a 15.6% decrease; p b 0.65). In the postimplementation period (FY 2017), only 21 cases were reported (an additional 44.7%decrease; p b 0.12), for a total decrease of 53.3% (p b 0.01). The mean number of days between injuries significantly increased(2.5 to 16.3) over the study period. For FY 2017, the main cause of BBPE was needlestick while suturing (47.6%); fellows andattendings combined had the most injuries (52.4%); among divisions, pediatric surgery (19.0%), operating room staff(19.0%), and orthopedics (19.0%) had the most events.Conclusion: A comprehensive and multidisciplinary approach to employee safety, focused on reduction of BBPE resulted ina significant progressive annual decrease of injuries among perioperative staff.