Sharps safety never stops

by Brian Ward

The 32nd World AIDS Day will be held on December 1 this year. Internationally recognized, the day is meant to raise awareness, support, and money for the estimated 38 million people with HIV/AIDS worldwide.

While the world is focused on the COVID-19 pandemic at the moment, other diseases like HIV/AIDS are still with us. In the U.S. alone, there were approximately 36,400 new HIV infections in 2018.

For that reason, laboratory workers and clinicians must remain vigilant in regard to needlesticks, sharps safety, and bloodborne infection prevention, says Dan Scungio, MT(ASCP), SLS, laboratory safety officer for multihospital system Sentara Healthcare in Virginia.

Q: Does the heightened focus on COVID-19 prevention have any tie-in to bloodborne pathogens safety? Is there an increased awareness of bloodborne pathogen safety because everyone is paying more attention to infection control in general? 

Scungio: There is definitely an increased awareness of bloodborne pathogen safety as a result of the COVID-19 pandemic. Employees who work in clinics, labs, and as medical couriers had new concerns about their personal safety on the job when the pandemic came to the U.S.

I dealt with many employees who were panicked about the idea of seeing sick patients, handling specimens, or transporting specimens. Many needed a reminder that they deal with bloodborne pathogens every day—including hepatitis and HIV, which can be more of a threat than COVID-19 virus particles. An overall heightened awareness about the importance of the use of standard precautions in healthcare jobs became necessary. Reminders about the use of PPE and proper hand hygiene were needed, including talking about the everyday existence of public high-touch surfaces like elevators and gas pumps.

Q: December 1 is World AIDS Day. What impact, if any, do you think this disease had on safety practices and general awareness around bloodborne pathogens? 

Scungio: The HIV outbreak of the 1980s and 1990s had huge impacts on healthcare safety practices and helped usher in a solid understanding of standard precautions—treating all patients and samples as if they are infectious. [Before,] many employees in healthcare commonly worked without gloves, lab coats, or face protection, and exposures (reported and unreported) were far more common than they are today.

The fear of working with HIV patients and specimens drove many in the workforce to finally comply with safer work practices and the use of PPE. Today, there are still those who do not utilize safe practices, but the COVID-19 pandemic has pushed some people into better, safer work habits.

Q: Do you think people have gotten better or worse at sharps safety and bloodborne illness management and response in the past couple of years?  

Scungio: Over time, people who work in healthcare in this country have become better with sharps safety and bloodborne pathogens, and some of that has to do with the enforcement of OSHA’s Bloodborne Pathogens Standard and standard precautions, as well as the Needle Safety Act. All needles are manufactured with a safety device (though they aren’t foolproof and many can be bypassed), and staff are to be part of the decision to choose a needle product.

That said, it is not difficult to find workplaces (labs, clinics, draw sites) where unsafe practices are the norm. While this is unfortunate, it tends to be the result of poor leadership and oversight, a lack of proper safety training, or a combination of the two.

Q: What does “sharps safety” look like within a culture of safety? 

Scungio: In a workplace with a strong safety culture, sharps safety starts with good training for new staff with solid supervision. Make sure the employee understands which needles to use and when. For example, butterfly needles are overused and cause the majority of phlebotomy needle stick injuries and exposures.

And watch to make sure they activate the needle safety device and dispose of the unit as quickly as possible after the needle is used. Staff should know when and how to change out a sharps container, and to never attempt to place a needle inside an overfull unit. Staff should also be prepared for incidents that could occur, such as a patient moving suddenly or passing out during a venipuncture. Thorough training and regular competency assessments should be done for those who use needles every day on the job.

Q: Have there been any innovations (equipment or policy) to sharps safety and bloodborne pathogen safety in the past 10 years? 

Scungio: Unfortunately, there has been very little movement. The OSHA standard has not changed since 1990, and while there have been a few needle safety product innovations, nothing significant has occurred which would drastically change the face of those fields. 

Q: What are the challenges or roadblocks to bloodborne pathogen safety that still exist? What can be done about them? 

Scungio: In my opinion, the biggest roadblocks include what I discussed earlier—staffing shortages, inadequate training, and a lack of safety oversight.

As always, the importance of safety needs to be at the forefront of the workplace, and awareness of safety issues must be made constant. Despite a lack of staff, employees should be fully trained on all aspects of sharps safety and bloodborne pathogen handling.

These areas are too important to be short-changed or ignored, and the consequences of an incident here can be career- and life-altering.

Now that you’re done reading this article, please take a moment to visit www.worldaidsday.org.