Add to Brochure

How evaluation can lead to improvement in sharps safety

March 17, 2015

Healthcare professionals know that delivering a high standard of care is crucial, and this encompasses sharps safety and other infection control practices. However, in addition to these procedures, it's also important to have a comprehensive scheme of evaluation in place. This enables nurses, doctors and other professionals, as well as the wider organisation, to identify areas where current practices are succeeding and where significant improvements can be made.

This was highlighted by a recent survey in the American Journal of Infection Control. It found that spotting areas in infection prevention practices where improvements can be made could allow staff to improve patient safety and care.

Conducted by Ascension Health, the 96-question survey canvassed the opinion of 71 of its hospitals across 23 states and the District of Columbia, with the aim of evaluating infection control practices for catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and surgical-site infections (SSI). 

It specifically looked at the current policies for placement and maintenance of devices, surgical procedures, evaluation of healthcare workers’ competencies, and outcomes evaluation.

According to the survey, the majority of hospitals had infection prevention policies in place for the use of devices, surgery, hand hygiene, and multidrug-resistant organisms. However, only just over a third (39.4 per cent) said they had policies concerning antimicrobial stewardship, such as antimicrobial restrictions. This is an area of particular interest at the moment, with antibiotic misuse leading to a global problem of resistance.multidrug-resistant organisms. However, only just over a third (39.4 per cent) said they had policies concerning antimicrobial stewardship, such as antimicrobial restrictions. This is an area of particular interest at the moment, with antibiotic misuse leading to a global problem of resistance.

It also found that many practices to reduce device risk varied between hospitals. In addition, while more than three-quarters of hospitals had a nurse-driven protocol for determining need for a urinary catheter, only just over a quarter of nurses (26.8 per cent) and even fewer patient care technicians (11.3 per cent) received training each year on how to properly place and maintain urinary catheters.

In order to minimise the risk of CLABSI, the vast majority of hospitals (94.4 per cent) reported using an insertion checklist. However, the survey found that just over half (59.2 per cent) used the checklist more than 90 per cent of the time, while just 40.8 per cent dedicated annual training to nurses on placing and maintaining venous catheters. 

According to the findings, a limited number of hospitals used electronic reminders to help nurses (8.5 per cent) and physicians (1.4 per cent) evaluate catheter need.

Surgeon-specific SSI rates were calculated and discussed with the surgeons in only two-thirds of the hospitals, a tool that may be important in helping surgeons prioritise infection prevention efforts.

“We suggest that individual hospitals evaluate their policies, processes, and practices prior to implementing interventions to establish a baseline for comparative purposes, to reduce infection, and base their action on the gaps identified,” state the authors. “We believe that identifying the gaps and addressing them as a system will help lead to marked improvements in safety for our patients.”

The findings of the survey can be extended to sharps safety. Risk assessments are the best method of determining what areas need improvement, and can even give you an indication of which departments and staff need targeted training.

Related Legislation and Guidelines: