Outline • Ontario Needle Safety Regulation • Ontario WSIB data and survey statistics • Prevention of injury: • using SEMS • Solutions from Ontario hospitals • Components of a comprehensive sharps safety program 23
Safety Engineered Medical Sharps Safety-engineered needle means, (a) a hollow-bore needle that, (i) is designed to eliminate or minimize the risk of a skin puncture injury to the worker, and (ii) is licensed as a medical device by Health Canada, or (b) a needleless device that, (i) replaces a hollow-bore needle, and (ii) is licensed as a medical device by Health Canada. (Ontario Regulation 474/07 – Needle Safety) 24
Ontario’s Needle Safety Regulation • Applies to HC work environments where workers use hollow-bore needles on persons for therapeutic, preventive, palliative, diagnostic or cosmetic purposes • Hospitals • Doctors’ and dentists’ offices, community health centres, family health teams • Home care, ambulance, public health, schools, occupational health services *sharps other than Hollow bore needles can still be dealt with under the general provisions of the Occupational Health and Safety Act and regulations 25
Ontario’s Needle Safety Regulations Summary: • All hollow bore needles must be safety engineered • Three exceptions will be allowed based on: • Cannot locate a safety engineered version commercially • The worker has reasonable grounds to believe there will be risk of harm • There is an emergency or crisis, the supply of safety engineered needles have been exhausted and waiting for new supplies would present a risk of harm to person or public interest 26
Engineered Control-Do safety features work to reduce injuries? • The CDC has reported on studies that showed that the use of SEMS among phlebotomists resulted in a reduction of up to 76%. (CDC, 1997) • NIOSH reports on studies that have reduction of rates ranging from 62% to 88% reduction in injuries (NIOSH, 1999) • Analysis of EPINet data collected in the USA shows a clear decline (51%) in the number of sharps injuries after implementation and use of safety engineered devices. (Perry, 2005). • Some hospitals in Ontario have reported large reduction in injuries within one year after use of safety engineered medical sharps were introduced. 27
WSIB Data
Health Care Sector Needle Stick Injuries by Claim Type Healthcare Needlestick Injuries by Claim Type 1600 1364 1400 1261 1148 1200 995 1000 800 626 600 400 200 76 74 71 58 28 0 2000 2005 2008 2011 2016 Lost Time No Lost Time Data Source: EIW Claim Cost Analysis Schema, August 2006, December 2012 and Feb 2018 snap shot.
Needle stick LTI Count by Rate Group 60 50 40 Sum of 2000 Sum of 2005 30 Sum of 2016 20 17 10 3 2 2 2 1 1 0 851 - Homes for 852 - Homes for 853 - Hospitals 857 - Nursing 858 - Group Homes 861 - Treatment 875 - Professional Nursing Care Residential Care Services Clinics and Offices and Agencies Specialized Services Data Source: EIW Claim Cost Analysis Schema, August 2006, December 2012 and Feb 2018 snap shot.
Needle stick NLTI Count by Rate Group 900 800 * PSHSA Survey results: In 2016- 13 700 hospitals recorded 592 Sharps injuries 600 500 Sum of 2000 Sum of 2005 400 289 Sum of 2016 300 200 119 78 100 69 33 16 13 0 851 - Homes for 852 - Homes for 853 - Hospitals 857 - Nursing 858 - Group Homes 861 - Treatment 875 - Professional Nursing Care Residential Care Services Clinics and Offices and Agencies Specialized Services Data Source: EIW Claim Cost Analysis Schema, August 2006, December 2012 and Feb 2018 snap shot.
Needle stick LTI Count by HC Occupation SECURITY GUARDS PSYCHOLOGISTS, SOC. SECURITY GUARDS TECHNICAL OCCUPATIONS IN PHYSICAL AND RELATED PSYCHOLOGISTS, SOC. WRKRS., AND RELATED SCIENCES , 1, 1% OCCUPATIONS , 1, 1% WRKRS., COUNSELLORS, COUNSELLORS, OCCUPATIONS , 2, 7% CLERGY & PROBATION , 1, 1% CLERGY & ASSISTING OCCUPATIONS IN PROBATION , 1, 4% PHYSICIANS, DENTISTS POLICE OFFICERS AND SUPPORT OF HEALTH SERVICES , 7, AND VETERINARIANS , FIREFIGHTERS , 5, 6% 8% 1, 1% PARALEGALS, SOC. ASSISTING CHILDCARE AND HOME SERV. WRKRS. & PARALEGALS, SOC. OCCUPATIONS IN SUPPORT WORKERS , 5, SERV. WRKRS. & OCCUPS. IN EDUC. & CHILDCARE AND SUPPORT OF HEALTH 6% OCCUPS. IN EDUC. & REL., NEC, 1, 4% HOME SUPPORT SERVICES , 4, 14% REL., NEC, 2, 2% WORKERS , 1, 3% OTHER TECHNICAL OCCUPATIONS IN CLEANERS , 1, 4% OTHER TECHNICAL CLEANERS , 8, 9% HEALTH CARE (EXCEPT OCCUPATIONS IN CLERICAL DENTAL) , 9, 11% MEDICAL HEALTH CARE (EXCEPT OCCUPATIONS, TECHNOLOGISTS AND OCCUPATION NOT DENTAL) , 4, 14% GENERAL OFFICE SKILLS TECHNICIANS (EXCEPT STATED , 2, 2% , 1, 1% DENTAL HEALTH), 2, MEDICAL 7% TECHNOLOGISTS AND TECHNICIANS (EXCEPT OCCUPATION NOT DENTAL HEALTH), 10, STATED , 2, 7% 12% NURSE SUPERVISORS AND REGISTERED NURSE SUPERVISORS NURSES , 33, 39% AND REGISTERED NURSES , 10, 36% 2016 2005 Data Source: EIW Claim Cost Analysis Schema, August 2006, December 2012 and Feb 2018 snap shot.
Needle stick LTI Count by HC Occupation Chart Title 35 30 25 20 15 10 5 0 … … … … … H T E & & S S S S D S S S S P R T N R R L E E R N E E . Y L L A E E S C E C T A G O A I C C K N R U T N K A I X R I E R U R H T A S H D E E T E H A O N G A I E E ( S T E L C N P F W L C L I C S T S D N F O C A I U I N O F R E , E I L T E S C F A N E R A T R . R H S R C O I T I R E C C P F O O O N O T N E I L I U D L S P N O V P A S I D L Y P I C N H I S P R G D E E H T C U N A U C S T E E A O N P S E O N A S N R P S A N E T & R U L N E U I D T M S E I G D E O C A I N . T R S S C N C C S O , P S N A R I S D N A O U I F H T , O N K N S F . O C N S S R I D O R O R A T I T C W T E N I O A S O K T D E S A A I S R P A C D P G . I L V , W U V I U E P A S R O L R C R U R N O A C C L E . C E A C I A C U C O P P N S O C I O O C G N C U H . D O C L I S H Y G S C S A L O L , T C Y N I E E S C H A S I H T E S T R I I C C , N T T R P S U R S I S I H R L U L G E C I S E A A C N H O E S L C G E S T L A C T I E O O D L E H A M C R Y A S P P 2005 2016 Data Source: EIW Claim Cost Analysis Schema, August 2006, and Feb 2018 snap shot.
PSHSA Survey results- April 2018 13 Ontario Hospitals provided data to 15 questions on Sharps injuries
Rates of Sharps injuries/ 100 FTE PSHSA Survey results- Sharps injuries/ 100 FTE 6 5 4 Rate/ 100 FTE 3 2 1 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Year A B C D E F G I J K L
PSHSA Survey results- Rates of Sharps injuries/ 100 FTE rate 3.5 3 2.5 2 1.5 1 0.5 0 2007 (8) 2010 (10) 2016 (11)
PSHSA Survey results Oc Occupa upation n Gr Group up expe perienc ncing ng the he most sha harps inj njur uries- 2006 2006 and and 2017 2017 5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Nurses Medical Physicians Other clinical staff Device cleaning Non-clinical technologists and and reprocessing support staff technicians staff 2006 2017 (Weighted average of occupation ranking from Highest to lowest)
In 2017 what medical devices contributed to the highest number of injuries (rank from 1-5 with 1 being the most frequent) 6 5 4 3 Score 2 1 0 syringes/hypodermic blood collection suture needles IV catheters Scalpel blades needles needles
In 2017, what department experienced the most injuries (rank from 1-5 with 1 being the most frequent) 6 5 4 3 2 Score 1 0 m t t g y ) w n n n r o o e e i o s o m m t s l a e r e t t r b g r r c o a a n o b y p p i r f a t e p i e a c L d d e e r e r p y e / p s c r y O a n l e p e c s p g a e u r e v e S l i p s m n ( E e r e t n h I t O
PSHSA Survey results- April 2018 Question Response All medical sharps have been replaced with SEMS where a replacement is available 30.77% All hollow bore sharps have been replaced with SEMS where a replacement is available 61.54% SEMS are available but occasional use of conventional devices occurs as per exemptions in the Needle Safety Regulation 69.23% SEMS are available, but some staff are still regularly using conventional devices as per exemptions in the Needle Safety Regulation 23.08% SEMS are available, but several staff are still regularly using conventional devices as per exemptions in the Needle Safety Regulation 0.00% SEMS are available, but some staff are still regularly using conventional devices even though their use does not meet the exemptions in the Needle Safety Regulation 0.00% SEMS are available, but several staff are still regularly using conventional devices even though their use does not meet the exemptions in the Needle Safety Regulation 0.00% Under reporting is listed as a recurring issue for sharps injuries. Do you feel this is still a concern? Responses Yes 25.00% (3) No 75.00%(9)
Sharps Injury Prevention
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