Aim: Implement ergonomic process improvement within the OR, to decrease incidence of injuries from sharps and needle sticks among the OR teams. Method: A pre and post intervention design was adopted. The number of reported incidents related to needle sticks and sharps over a seven month period prior to the implementation of the ergonomic process improvement(January to July 2014) and over a seven month period following implementation(January to July 2015), were compared. A participatory approach was adopted, for conducting the study and the study team included an ergonomist, surgery educators, two surgeons, operations leader, department manager, team lead, risk manager and two pre-med students functioning as study assistants. Ergonomics training for the prevention of injuries from sharps and needle sticks was developed, which incorporated physical, cognitive and teamwork measures alongside the prevention measures outlined by AORN and evidence based measures identified following a literature review. The Surgery Educator, the Ergonomist and an Attending Surgeon, participated in delivering the ergonomics injury prevention training. The management, including the Team Lead and OR Manager participated in supporting and facilitating the implementation of the injury prevention measures, where possible, such as double gloving; safe passing zones; verbal feedback; silence or task related communications only during critical phases, etc. Results: A significant difference was found in the frequency of the overall sharps and needle stick related incidents over the pre and post implementation time periods of interest(Wilcoxon Signed Rank test - significant at p≤ 0.05 level, where the W-value is 2 and the critical value for W with N=6 is 2). 63.51% decrease in incidence rate was found among the OR staff, and 44.25% decrease in incidence rate was found among students and residents, pre and post implementation. Overall, a 55% decrease was found in the incident rate of events related to sharps and needle sticks among the OR teams(experts and novices combined), over the first seven months of implementing the ergonomic process improvement. Conclusion Within the complex task and team work environments of the operating room in teaching hospitals, ergonomics and human factors fundamentals related to individual task performance, team work and work design could help improve the effectiveness of the safety measures.

The risk of a needle stick or sharps injury in the operating room (OR) is high due to conditions such as minimal physical protective measures, frequent transfer of sharps, and reliance on human attention and skill for injury avoidance. An ergonomic process improvement project was initiated at a large metro teaching hospital to identify ergonomic risk factors for these OR injuries. To maximize the engagement of the front- end users, an ergonomic process improvement (EPI) team was developed, consisting of representatives from participating OR teams, an employee health nurse and two ergonomists. Surveys, observations, and interviews were conducted to quantify injury risk for the OR teams, evaluate barriers to best practice adherence, and identify opportunities for targeted interventions. Risk mapping was completed for the surgeons, surgical techs and OR nurses identifying double gloving and safe passing zone as areas in need of improvement. Through observation and interviews, researchers identified physical factors relating to musculoskeletal pain and cognitive factors leading to distractions as safety risk concerns. The overall success of the EPI was the engagement of the OR teams and surgeons in the process of identifying risk factors and potential opportunities for ergonomic solutions related to cognitive workload, physical workload, teamwork, and work design for injury prevention. The risk factors identified will provide the basis for developing targeted, effective interventions for eliminating injuries from needles and sharps within the OR.