INFECTION CONTROL NEWSLETTER

March 1999
written by and for Long Term Care Infection Control Nurses

Broad Street Solutions
James Marx, RN, MS, CIC Editor
PO Box 16557
San Diego, CA 92176
(619)656-7887 Voice/FAX
jmarx@concentric.net

New OSHA Sharps Injury Log now required in California

The California OSHA Board has enacted emergency legislation and changes to the Bloodborne Pathogens Standard. This is the first change in the Standard since it was created in 1991. The Sharps Injury Log is now required as part of a post blood exposure follow-up. It must contain certain elements and be completed within 14 working day of the date the incident is reported to the employer.

The information recorded must include the following information, if known or reasonably available:

(A) Date and time of the exposure incident;
(B) Type and brand of sharp involved in the exposure incident;
(C) A description of the exposure incident:

Job classification of the exposed employee;
Department or work area where the exposure incident occurred;
The procedure that the exposed employee was performing at the time of the incident;
How the incident occurred;
The body part involved in the exposure incident;
If the sharp had engineered sharps injury protection, whether the protective mechanism was activated, and whether the injury occurred before the protective mechanism was activated, during activation of the mechanism or after activation of the mechanism, if applicable;
If the sharp had no engineered sharps injury protection, the injured employee's opinion as to whether and how such a mechanism could have prevented the injury; and
The employee's opinion about whether any other engineering, administrative or work practice control could have prevented the injury.

In an effort to be in compliance, the facility should in revised the Bloodborne Pathogens Exposure Control Plan to include this information. You should also include who is responsible to see that the information is complete. Broad Street Solutions recommends that you amend the post-blood exposure form you are already using, rather than create a different form. If you facility needs help with compliance, please contact our office.

In addition to the new Sharps Injury Log, the facility is now required to include hepatitis C as part of the post blood exposure follow-up. This means that the source and the employee should be tested at the time in exposure.

If you would like a copy of the new California Bloodborne Pathogens Standard, contact the California OSHA Standards Board at 916-322-3640.

Engineered Sharps Safety Devices

In an effort to reduce the number of sharps injuries in California, California OSHA will require the use of needleless systems, needle devices with engineered sharps injury protection and non-needle sharps with engineering sharps injury protection to be used in all settings were sharps injuries may occur by July 1, 1999. While there are some exceptions to the regulation, this means that skilled nursing facilities will need to evaluate all sharps used in the facility, determine if there is a safety device on the market to prevent injury from that sharp and begin using the new devices after the July 1 deadline.

To begin the process, make a list of all sharps, needle and non-needle used in the facility. Be sure to include each type and brand of device. Next get a list of products that have a engineered sharps injury protection as part of that device. For example, if you have a 3cc syringe with attached 23 G needle, you may want to contact the following manufacturers:

Becton Dickenson- Safety Lok Syringe
Becton Dickenson- Saftey Gluide Sheilding Injection Needle
Sherwood Medical- Monoject Syringe
Retractable Technologies- Vanish Point Syringe

Expect to pay 3-5 times the cost of your current syringe and needle. This will amount to $200-400 per 100 bed facility.

When making your list of non-needle sharps, do not forget to include fingerstick lancets, razors, scissors, and scalpels. At this time, we are not aware of any safety devices manufacturer for razors, scissors, and scalpels.

Contact your laboratory and pharmacy and ask what they are doing to provide safety devices to blood drawing and IV therapy.

Finally, call the California Sharps Injury Control Program for a up-to-date list of safety devices at 510-622-4300.