OR Manager - August 2018 - 21

Patient safety
Figure 1. Suture sharps injuries compared to all other major device types, by percent, 2016.
Figure 1. Suture sharps injuries compared to all other major device types, by percent, 2016.
Syringes, 26.5%
Syringes, 26.5%
Disposable
Disposable
Other, 35.8%*
Other, 35.8%*
however, only 0.2% of injured employees
stated that they were using a device
with a safety design.
Financial burden
Blood Collec:on,
5.3%
Venous/Arterial
Catheter, 2.1%
Scalpel Blade, 5.7%
Scalpel Blade, 5.7%
Suture, 24.6%
Suture, 24.6%
*Other devices include pins, drills, spinal needles, scissors, glass, etc, all with frequencies
1.0% or less.
Source: Amber H. Mitchell, DrPH, MPH, CPH. Used with permission.
Figure 2. Suture sharps injuries by professional category, by percent, 2016.
Figure 2. Suture sharps injuries by professional category, by percent, 2016.
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
0.00%
5.00%
0.00%
5.00%
*Other devices include pins, drills, spinal needles, scissors, glass, etc, all with frequencies
1.0% or less.
Source: Amber H. Mitchell, DrPH, MPH, CPH. Used with permission.
Venous/Arterial
Catheter, 2.1%
Blood Collec:on,
5.3%
Source: Amber H. Mitchell, DrPH, MPH, CPH. Used with permission.
Source: Amber H. Mitchell, DrPH, MPH, CPH. Used with permission.
and outpatient clinics or office settings
(1.3%). Sutures used in other units
or departments, including procedure
rooms, catheter labs, and labor and
delivery, represent less than 5% of the
total, according to EPINet data.
Suture injuries, more so than all
other devices causing injuries in the OR,
happen almost 70% of the time during
use and less than 20% of the time between
steps of a multistep procedure.
This may mean that, compared to other
devices used during surgical procedures
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(scalpels, trocars, multidose syringes,
etc), sutures are less frequently used
multiple times.
In 2015-2016, physicians sustained
the highest percentage of suture injuries
(57.2%), followed by surgical attendants/technicians
(16.1%), and nurses
(14.4%) (Figure 2, above). Safer options
for suturing include blunt sutures for
internal fascia (nonskin closure), adhesives
(for skin closure), staples, and zip
tie-like closures. For all suture injuries
occurring in the last 2 reporting years,
Determining the exact cost of needlesticks
and sharps injuries is difficult
because the situations involving each
exposure are different (eg, type of exposure,
amount of blood, amount of bleeding,
source patient status, time to receive
medical follow-up, emotional distress,
time away from work). Statistics
in the peer-reviewed literature suggest
that managing occupational exposures
can range from $375 to $2,456 per incident
if there is no seroconversion, and
up to $1 million or more if there is.
There are direct and indirect costs
associated with each incident and injury.
There is also a financial burden associated
with failure to comply with the
Occupational Safety and Health Administration's
(OSHA) Bloodborne Pathogens
Standard (29 CFR 1910.1030)
should an inspection take place. Violations
of the standard are typically categorized
as " serious " violations because
they can result in serious physical harm
(bloodborne infection/illness) and up to
$12,934 per cited violation.
This fine can add up quickly as the
dollar amount is then charged per day if
the employer does not fix the hazard beyond
an agreed-upon abatement date.
If it is determined during the inspection
that an employer willfully violated the
requirements of the standard, fines can
be as high as $129,336 per violation.
Cost should not be the primary driver
of change, but it seems to be the most
compelling reason to move to safer
technologies to prevent occupational
exposures. The costs illustrated above
are related to the employee incident
itself, and do not include the liability
costs associated with potential patient
exposures.
If an injury occurs to an employee
inside the sterile field (eg, a suture
pierces through double gloves, resulting
Continued on page 22
OR Manager | August 2018 21

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OR Manager - August 2018

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