Implementing AORN Recommended Practices for Sharps Safety

Abstract

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN "Recommended practices for sharps safety" clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving.

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

“…A hierarchy for reducing percutaneous exposure includes eliminating sharps completely when able and using safety-engineered devices when sharps are absolutely necessary. 21 Evidence supports the use of blunt-tipped suture needles to reduce glove perforation and needle-stick injury, and the use of safety-engineered scalpels, needles and syringes is best practice. [21][22][23][24] When sharps are required, standard procedures for passing and handling these items are important.…”

“…Many injuries occur during hand-to-hand passing or handling of sharps. 21 Placing sharps in a neutral zone rather than passing hand to hand, and using instruments or packaging to handle sharps rather than handling them directly are important safety measures. It is important is to build a culture of safety within the operating room, recognizing that safety is important for both the patient and the surgical team.…”

An Integrative Review of the Hands‐Free Technique in the OR

“…Although suturing appears to account for the greatest number of sharps injuries, passing needles, scalpels, and other sharps is associated with an estimated 8% to 27% of injuries in perioperative areas 11,17,18 . The HFT, in which the hands of no two perioperative personnel ever simultaneously touch a sharp, has been widely recommended by various perioperative disciplines as a best practice to prevent these injuries 19‐21 . With procedures for which surgeons need to maintain an uninterrupted view of the operative site, AORN suggests a modified HFT approach in which scrub personnel carefully place the sharp in the surgeon's hand, and the surgeon returns the sharp to the neutral zone after use 22 .…”

“…Studies also varied in the terminology used to measure and report use of the HFT. Some researchers asked those surveyed to rate the frequency of the use of strict no‐touch technique (ie, from always to never) 19,39 . Several asked about the use of hands‐free passing (ie, never avoid/avoid) 18,36 .…”

Epidemiology of hepatitis B and C virus infections among patients who booked for surgical procedures at Felegehiwot referral hospital, Northwest Ethiopia

“…Viral hepatitis is a serious bloodborne, sexually, vertically, and feco-orally transmitted systemic communicable disease [1,3]. It can also be transmitted through the reuse of inadequately sterilized medical equipment, surgical procedures, and tooth extraction practices [4][5][6]. HBV and HCV are responsible for 96% of all hepatitis mortalities worldwide [7].…”