How many sharps injuries occur each year?
In 2010, the European Council described sharps injuries as one of the most serious health and safety threats in European workplaces as an estimated one million injuries were occurring each year. (1)
Please can you outline the UK’s Health and Safety (Sharps Instruments in Healthcare) Regulations 2013 and the EU Directive?
The European Council Directive on sharps injury prevention (Council Directive 2010/32/EU) was issued in 2010 to help prevent the estimated one million sharps injuries occurring in the European Union each year. All EU member states were mandated to incorporate the Directive into national law by 11th May 2013.
The Directive applies to all workers in the hospital and healthcare sector. It states that “Employers and workers’ representatives shall work together to eliminate and prevent risks, protect workers’ health and safety, and create a safe working environment.”
It requires resultant legislation to enforce thorough risk assessment when injury, blood or other potentially infectious material is possible or present. It must also focus on how to eliminate such risks.
The suggested risk management measures are: specifying and implementing safe procedures (including safe disposal), eliminating unnecessary sharps use, providing safety-engineered medical devices, prohibition of recapping, coherent overall prevention policy, training & information, personal protective devices and offering vaccination.
Workers are obliged to report any accident to the responsible person and the incident should be investigated and the victim treated.
The UK has met the deadline by incorporating the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 into national law. They require employers to eliminate unnecessary sharps use and have effective arrangements in place for the safe use and disposal of sharps.
‘Safer sharps’ (also known as safety-engineered medical devices) must be used where reasonably practicable.
The practice of recapping of needles will also be restricted and sharps bins must be stationed close to the point of use to encourage safe disposal.
Workers are obliged to report any accident to the responsible person, and employers are required to investigate and take action in response to work related sharps injuries, however emphasis must also be placed on providing the necessary information and training to all those that come into contact with sharps.
Why was this regulation put in place?
Regardless of the actual number of sharps injuries suffered in the healthcare environment, being put unnecessarily at risk in the course of their work, is unacceptable in a civilised society.
Contracting, for instance, Hepatitis B through a sharps injury can mean then end of someone’s career in the healthcare environment. This is an appalling and avoidable human cost.
From the point of view of the healthcare institution, such infections can result in expensive litigation and compensation, diverting pressurised funds from their intended use – frontline diagnosis, treatment and care.
The combined human and economic case for tightened safety legislation regarding sharps usage was therefore a highly compelling one.
The Regulations legally bind healthcare employers and are expected to dramatically assist healthcare organisations with their transition to a safer working environment. They will need strict enforcement, however, to achieve optimal effect.
How are NHS Trusts adjusting their sharps policies to comply with the EU Directive?
In overview, our research shows that a majority of Trusts (84%) are taking the issue very seriously, insofar as they have revised their safety policies to reflect the EU Directive and the resulting local legislation.
Of course, the counterpoint to this positive finding is that around one sixth of Trusts do not seem to feel they need to change their policies at all. In some cases this will be justified, with existing policies that encourage or instruct the use of safer devices and procedures.
However, it is of deep public concern that there are other instances where Trusts appear to be ignoring the issue. If this is the case, then serious regulatory action and penalties may ensue.
Policy change is not enough, however. Widespread implementation of the new regulation must be seen in short order if the legislation is truly to radically improve healthcare worker safety, as it is intended to do.
Certainly, it appears from our research that cannulation and phlebotomy (two areas where sharps usage is very high, and therefore risk of sharps injury is greatest) are very well advanced, with widespread use of safety devices.
We do expect the conversion to a safer environment will not happen immediately. Nevertheless, it is noticeable that there is a small but significant proportion of Trusts that are already using safety alternatives almost universally in certain procedures.
In our view, the majority of Trusts will have achieved almost 100% implementation in the most at-risk areas by some point in 2015.
According to the research conducted by MindMetre over July-December 2013, how many NHS Trusts are encouraging their staff to use safety devices ‘wherever possible’?
Even though most safety policies do not absolutely mandate the use of safety alternatives, on the basis that some very specialised procedures (e.g. neo-natal) need to use non-safety devices, or that safety alternatives do not yet exist for every application, responsible Trusts encourage safety device usage by explicitly saying in their policies that they should be used “wherever possible”.
67% of Trusts include this clause in their safety policy. We believe that this majority will gradually seep through to the 33% of Trusts not including the clause, in that majority best-practice will probably come to be regarded – both in procedural and litigation terms – as the norm.
What are your thoughts on these findings? And what are MindMetre’s plans for the future?
To see majority movement in UK NHS Trusts towards properly protecting their workers is, of course, a good thing. It is good for the ethical standards and duties of our health service to provide a safe working environment.
It is a good practical move by compliant Trusts also to improve healthcare worker satisfaction and retention.
And it is a good policy to invest in compliance in order to reduce legal and compensation risk, ultimately thereby making better use of the taxpayer’s money.
At the same time, we were disturbed to see a smaller proportion of Trusts apparently not yet complying with the new regulation, and it is to be hoped that the actions of the majority will influence and inspire the slow-paced minority into more urgent action, especially if joined by scrutiny from the regulatory authorities.
MindMetre will be continuing its own close research on the issue, in order to provide the public and stakeholders with an independent view of progress in this area.
Where can readers find more information?
The full report is available online at: www.mindmetreresearch.com/wp-content/uploads/2014/02/Safer-sharps_A-barometer-of-take-up-in-the-UK_report.pdf
About Paul Lindsell
In 1993 Paul founded the first of a number of marketing services businesses. Since 2009, he also devotes his time to running and developing MindMetre Research, a market research company with clients in technology, finance, retail and a number of other sectors.
Paul has successfully grown several businesses advising and supporting organisations large and small on their marketing and communications requirements, particularly on how to integrate marketing with sales to produce bottom-line results. These organisations range from giants such as Siemens, Kingfisher Group and Regus, to small but dynamically growing firms.
Paul has developed his companies through a twenty year period of massive technological change, changes in business practice and economic uncertainty. He has developed those businesses to compete ahead of market developments, now operating across countries from the USA, through Europe, to Russia, India, China and Australia.
Paul also offers a particular expertise in grasping the power of the internet, mobile and social media, while retaining balance and integration with traditional media that still play a critical part in reaching and influencing audiences and markets.
He has played a leading role in the development of thought-leadership marketing, the art of positioning companies as leaders in their field by researching and publishing insights into those companies' markets in order to demonstrate the company's expertise to customers, stakeholders, shareholders and influencers.
Throughout his career, Paul has mentored and guided the marketing function- on a pro bono basis - for a range of charitable organisations.
He is also co-founder of The Data Governance Forum and founder of the European Supply Chain Finance Forum.
(1) EU Commission for Employment, Social Affairs and Inclusion, New legislation to reduce injuries for 3.5 million healthcare workers in Europe, 8th March 2010. http://europa.eu/rapid/press-release_IP-10-243_en.htm