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With the recent attention being paid to preventing needlestick injuries among health care providers, a resource made available by Arlington, TX-based Johnson & Johnson could come in handy in helping you weigh the benefits and disadvantages of switching to needleless devices and tubing systems.
Occupational Exposure to Blood: Clinical Implications and the Financial Impact of Accidental Occupational Exposure to Blood is a 14-page guide providing invaluable information to providers, ranging from various risk factors and charts on at-risk devices, as well as a worksheet on the financial impact of needlestick injuries and a three-page guideline highlighting the management of occupational exposure to blood.
"We found that there was a two-part need when dealing with occupational exposure to blood," says Sheila Beuerlein, group product director for IV catheters at Johnson & Johnson. "First, clinicians needed a formalized plan to address treatment following occupational exposure to blood. Our goal for the treatment protocol was to put the CDC [Centers for Disease Control and Prevention] guidelines in a user-friendly algorithm format."
Second was the need of a way to accurately assess the potential cost of needlesticks.
"We found that institutions need to understand the cost of a needlestick injury, should it occur," says Beuerlein. "From our discussion with end-users, we found that assessing cost was virtually impossible due to the numerous factors involved and varying treatment costs. Our goal was to help walk the clinician through all possible costs presenting average costs based on information contained in the open literature."
The cost worksheet allows the clinician to input the cost data appropriate for that institution while providing sample costs for comparison. Beuerlein notes the cost worksheet is critical in showing the full extent of costs involved in treating needlestick injuries, incorporating both direct and indirect costs. (See charts on pp. 66-69 in this issue.)
According to Beuerlein, direct costs associated with needlestick injuries include chemoprophylaxis agents such as AZT or similar protease inhibitors drugs to prevent HIV seroconversions. While expensive, such costs are easy to assess; it’s the indirect costs that can be overlooked.
"Indirect costs are difficult to assess, such as the loss of work due to reporting time, evaluation, and treatment; not to mention costs due to drug side-effects, increased stress, and anxiety," says Beuerlein. "Then, there are other indirect costs which are the most difficult to predict but can be the most costly, such as costs due to injury claims and OSHA fines."
Beuerlein notes that approximately one-third of providers use safety catheters, but a lack of awareness of the truly high-risk devices provides a major obstacle when providers consider switching to safety devices.
"The greatest hurdle in switching to safety devices is the lack of awareness of the risk associated with a needlestick injury," she says. "Not all needlesticks are created equal. A needlestick with a hollow-bore, blood-filled needle is much more dangerous than one from a clean hypodermic needle which has not been previously placed in a patient’s vein."
A second hurdle, according to Beuerlein, is getting providers to understand that many needlesticks are never reported.
"National studies have shown underreporting rates ranging from 29% to as high as 96%," she says. "These figures show that the problem is likely worse than an institution may realize."
As a result, the key is in educating providers and clinicians in the risks of needlesticks and an understanding of the areas of concern.
[Editor’s note: For a copy of the Johnson & Johnson publication, call your local Johnson & Johnson sales rep, or (800) 255-2500.]