OR Manager - August 2018 - 23

Patient safety
* skin glues, where incision edges
are chemically bonded together and
are not subject to distraction forces
* adhesive strips for minor lacerations
and small incisions
* zip tie-like adjustable skin closures
(photos, p 22).
During device evaluation in your facility,
assess the pros and cons for
patients and personnel, and document
these in the Exposure Control Plan.
Many of the manufacturers and
distributors for alternative technologies
provide in-services, training, and
ongoing education. Employers must
ensure that training is done not just
annually, but as new devices are
implemented and used and as new
employees who will be using those
devices are onboarded.
There may also be studies to aid
in the evaluation and final selection
of engineering controls designed to
reduce sharps injuries and improve patient
outcomes. These studies include
information on patient outcomes, cosmetic
outcomes, differences in surgical
site infection rates or risk, effectiveness
of different types of closure
procedures, staff satisfaction, and
ease or difficulty of use. A facility may
want to incorporate elements and outcomes
like these in a suture alternative
evaluation checklist.
Ultimately, given the high prevalence
of injuries in the OR and suture injuries,
the requirements of the OSHA Bloodborne
Pathogens Standard, and potential
for improvements in safety, quality,
and aesthetic outcomes, healthcare
administrators and employers are encouraged
to evaluate and implement alternative
suture and skin closure technologies
wherever feasible. ✥
Amber H. Mitchell, DrPH,
MPH, CPH, is president and
executive director, and
Ginger B Parker, MBA, is
chief information officer/
deputy director of the International
Safety Center, a
nonprofit research and advocacy
organization for safer
healthcare workplaces.
References
Occupational Safety and Health Administration.
OSHA Bloodborne Pathogens
Standard 29 CFR 1910.1030.
https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_
table=standards&p_id=10051.
O'Malley
E M, Scott R D, Gayle J, et al.
Costs of management of occupational
exposures to blood and body
fluids. Infect Control Hosp Epidemiol.
2007;28(7):774-782.
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