GENE O’CONNELL – RN, MS
An open letter from the Past Chair of National Association of Hospital Administrators, Past CEO of San Francisco General Hospital.

Congressman Frank Pallone
Healthcare Sub-Committee Chair
2125 Rayburn House Office Building
Washington, D.C., 20515

Dear Congressman Pallone,

I commend Senator Waxman’s Sub-committee hearings on Medical Devices on June 18, 2009 as a critical component of healthcare reform to bring before Congress issues of regulatory oversight to ensure safe, cost effective medical devices that provide better healthcare.

Nowhere in the transcript of testimonies by the four prominent witnesses on June 18, 2009 was there mention of the historic U.S. Needlestick Safety and Prevention Act 2000. Internationally, this uniquely American legislation is the foundation for parliamentary discussions of healthcare reform around the world. The Needlestick Safety and Prevention Act is held as the highest standard of humanistic and wisdom-filled governance to ensure patient and healthcare safety. Furthermore, the Act addresses the enormous hidden costs of needlestick injuries to society. Dr. William Maisel stated the case succinctly that healthcare reform in America would improve if we only implement current laws.¹

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CATHIE GOSNELL-RN,MS,MBA
Former Executive of Premier, Inc., (Largest Medical Device Purchasing Organization Worldwide)
Safety Consultant to the Premier Safety Institute, (Gosnell Clinical Consulting).

Needlestick injuries can occur at any time during the use or disposal of a needle or sharp device.  While many injuries occur after device use and during disposal, up to 40 percent of injuries occur during use.  During use injuries can be some of the most difficult to prevent.  Most needlestick safety devices are designed to protect the sharp either before or after use; however a needle while in use is necessarily unprotected.

Needlestick safety devices or engineering controls; therefore, offer little protection against injuries that occur during a procedure. Work practice controls have been the primary method to reduce during procedure needlestick injuries. Such methods include:

• Implementing non-invasive techniques that do not require needles whenever possible
• Thorough training to develop practitioner confidence in the use of needles and other sharp devices
• Limiting interruptions during procedures
• Explaining the procedure to patients to gain their cooperation and avoid potential movement during the procedure
• Asking for assistance with patients that might be uncooperative, such as children

Strategies such as these remain the only method to prevent during the procedure injuries for most procedures.  However, the recent availability of phlebotomy devices that include vein entry indication (VEI) technology could provide a reduction in needlestick injuries during blood drawing procedures. Read more

AMBER HOGAN MITCHELL – MPH, DrPH
Senior industrial hygienist at the U.S. Department of Labor OSHA specializing in national regulatory enforcement issues. OSHA National Bloodborne Pathogens Coordinator.
Copyright 2009 by Virgo Publishing.
http://www.infectioncontroltoday.com/

Occupational exposure to sharps contaminated with bloodborne pathogens continues to be an occupational health and safety concern among workers providing patient care. Sharps injuries have been substantially reduced in acute-care settings through increased awareness, thorough training, and technological advancement of safety engineered needles on syringes, blood collection devices, IV insertion sets and lancets. Within these families of devices, there have been multiple generations of safety designs that require the user to actively slide a sheath, flip a clip, advance a plunger, or add an extra aggressive push. Today, there are very few safety-engineered medical devices that require no active step to make a device safer during use, after use and prior to disposal. This brief report is an analysis of current national guidance for passivity in safety engineered medical devices. Read more

As a Nurse for 35 years I feel great pride to be a part of something so wondrous and ever changing as the medical field. The speed with which our medical science innovations have developed during my nursing career is extraordinary! It has also been wonderful to participate in the attitude changes that have taken place over the years. Patients have become much more active in their health care and thanks to the internet are much more informed when they see a physician. Patients are asking very detailed and intelligent questions and are now used to making information based decisions about their health and are active participants in their health care. Interestingly, we (I include myself) have never really questioned getting our blood drawn. None of us like it (some less than others) and none of us would let anyone poke a hole in us if we didn’t think it was absolutely necessary. So we each reluctantly stick our arms out and hope the person doing it knows what they are doing.

As a nurse I have spent a great deal of time accessing veins. My ego found joy in that I seemed to have the ability to get in a vein on the first try. I had a “visualization” technique I utilized. I was always a little nervous preparing to draw blood because I didn’t want to cause the patient any more discomfort than necessary. More importantly, I knew that once I missed the vein the patient would lose confidence in my ability as a nurse. Even worse, I would lose confidence in myself which would make the second attempt even more difficult. I developed a “3 strikes I’m out” policy. Some of my colleagues have developed the “if I can’t get it (the vein) then no one can” attitude and have stuck a patient many times to obtain a blood sample. As with most professions there are a lot of egos in the medical field. Read more