Ergonomics and Prevention of Injuries From Needles Sticks and Sharps in the OR

Abstract

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.

Ergonomic Process Improvement for Mapping Risk and Identifying Key Interventions for Eliminating Injuries from Needles and Sharps in the OR

“…The following risk reduction strategies were extracted from Davis(2001) "Advanced Precautions in the OR"; Revised Statement on Sharps Safety(ACS, 2016); AORN, Sharps Safety, 2019 and Ergonomics and the prevention of NSIs in the OR (Kalaga, Balters and Crowley, et al, 2017). Two OR Ergonomics Surveys were created.…”

“…Surgical tasks take place within a relatively small, constrained space, involving multiple hands in close proximity with moving sharps and minimal engineering controls to provide protection from injury. Kalaga, Balters, Crowley, et al,(2017) reported a process improvement study at a teaching hospital which included physical, cognitive and psychosocial ergonomic interventions, for reducing NSIs in the OR. They incorporated the successful interventions reported in the literature, and expanded ergonomic interventions for preventing NSI, including techniques for preventing localized fatigue/pain; cognitive aspects of managing attentional resources and team work, within the three phases of the OR task.…”