1. Weed out non-
safety sharps.
We first
identified when, where and
why we were using non-
safety sharps. We replaced
non-safety sharps with safe-
ty ones where appropriate.
If non-safety syringes were
used to simply draw med-
ication from a vial and
never used on a patient, we
allowed their continued use.
We remain open to replac-
ing all non-safety sharps, including scalpels, and have trialed all kinds
— those with disposable plastic handles, with reusable metal handles,
with safety sheaths and with retractable blades.
2. Correct high-risk behavior.
The OR was a high-risk pop-
ulation cluster for sharps injuries. We reinforced best practices there:
• Don't re-use syringes for lidocaine injections. Some doctors
want to reload lidocaine into the syringe, because it's quick and effi-
cient and the vial poses no infection threat because it gets thrown
away after that procedure. But the syringe has already been in the
patient, so it poses a risk to the staff. Explain to your surgeons why
it's important to not re-load. And educate your nurses on ways to keep
efficiency high after the change. Tell them to have several syringes
pre-loaded, or on hand ready to load. Make sure they activate the safe-
ty feature when the surgeon is done with it. Reinforce all of this in
huddles and time outs.
• Eliminate hand-to-hand sharps transfers. Create a neutral zone
D E C E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 6 7
• NEUTRAL ZONE Creating a hands-free area helps reduce injuries that
occur by eliminating hand-to-hand sharps passing. OR team members
place and retrieve sharp instruments on a brightly colored towel or tray.
Pamela
Bevelhymer,
RN,
BSN,
CNOR