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OSHA and NIOSH: Use blunt suture needles
Devices reduce injuries in OR
Consider yourself forewarned: It's time to switch to blunt suture needles in the OR.
In a rare joint bulletin, the U.S. Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health advise hospitals that "employers must use safer devices to replace corresponding conventional sharp-tip suture needles in their workplaces when clinically appropriate."
Both the American College of Surgeons and the Association of Perioperative Registered Nurses (AORN) have endorsed the use of blunt suture needles for suturing fascia. The bulletin notes that more than half (51% to 77%) of percutaneous injuries in the OR are caused by sharp suture needles.
Many hospitals have faced resistance from surgeons, who are concerned that the blunt needles will not perform as well. But three New York hospitals experienced a dramatic reduction in injuries due to blunt suture needles when the devices were implemented in gynecologic surgery in 1994, according to the bulletin. Other studies also have shown that blunt suture needles are "technically satisfactory" and effective in reducing injuries, the bulletin says.
The main barrier is a cultural one. Switching to a new device and technique always is challenging, says Larry Reed, MS, deputy director of the Division of Surveillance, Hazard Evaluations, and Field Studies at NIOSH in Cincinnati.
"I think it will be difficult [to change], but I am optimistic that we can have some significant impact in terms of injury reduction," says Reed.
The bulletin arose out of a NIOSH-sponsored sharps safety workshop held last year. "There was a clear sense of strong concern that we should be telling OR health care personnel about [the benefits of] these blunt instruments," he says.
The "encouragement" to use blunt suture needles is made stronger by OSHA's enforcement of the bloodborne pathogen standard. It is the most frequently cited standard in hospital inspections.
Hospitals are required to implement sharps safety in the OR. "Where an employer has determined that the use of available safer devices is not feasible, the clinical justification for this determination must be documented in the facility's Exposure Control Plan and the employer must implement alternative means of protecting surgical personnel from percutaneous injuries," the bulletin states.
(Editor's note: A copy of the bulletin is available at www.osha.gov/dts/shib/shib032307.html.)