New regulations may affect the way you use hollow-bore needles to treat your patients. Here’s what you need to know.
Changes to WorkSafeBC’s Occupational Health and Safety Regulation (OHSR) that came into effect on 1 January 2008 affect all medical practitioners who use hollow-bore needles to treat or care for patients. These changes were made in response to the estimated 5000 needlestick injuries BC health care workers sustain each year.
Any medical procedure that involves the use of hollow-bore needles now requires safety-engineered needles or needleless systems. These procedures include:
• Withdrawing body fluids.
• Accessing veins or arteries.
• Administering medications or fluids.
• Any other procedure—for example, immunizations—involving the potential for an exposure to accidental parenteral contact for which a needleless system or safety-engineered needle system is available.
Do these changes apply to you?
The OHSR applies to all workplaces in the province. This includes medical offices, clinics, hospitals, long-term care facilities, and patients’ homes where medical practitioners treat or care for a person. Since suppliers are also covered by these requirements, needles that are available on the market may change.
Are there any exceptions?
There are only two instances where conventional needles can still be used for medical procedures:
1. When a safety-engineered needle is not commercially available to replace the conventional needle and no alternative systems (such as patches or jet injectors) are available to eliminate the use of the needle.
2. When the use of a safety-engineered needle or needleless device is not clinically appropriate because either the medical practitioner or patient would be at increased risk of injury. This determination can be made by educated, trained, and experienced persons—such as medical practitioners—who are knowledgeable about the work and hazards involved and the means to control these hazards.
The use of safety-engineered needles or needleless devices may require modification of a medical procedure. This alone does not necessarily mean that the use of the required device, needle, or sharp compromises patient care or safety or worker safety.
What if there are choices?
If there are two or more types of safety-engineered needles commercially available that are clinically appropriate for a medical procedure, you must select the device that provides the highest level of protection from accidental parenteral contact. The following should be considered in determining the highest level of protection:
• Evidence of reduced risk of exposure.
• Consideration and review of the different types of engineering controls that are commercially available.
• Information provided by manufacturers or independent testing agencies, objective product evaluation, or other reliable sources.
• Periodic review to ensure that the devices selected are appropriate based on the most current scientific knowledge of protection from sharps injuries.
Will there be further changes?
Yes. Effective 1 October 2008 any medical sharp—including sutures, scalpels, and lancets—used to treat or care for a person must be a safety-engineered medical sharp. The same criteria and exceptions that apply to hollow-bore needles will apply here.
Where is more information available?
For more information, visit our web site, WorkSafeBC.com, for both the regulations and guidelines associated with these changes—Reference OSHR 6.36(1)—or call the Prevention Information Line at 1 888 621-7233 to contact your local WorkSafeBC occupational hygiene officer.
Industry Specialists, WorkSafeBC Health Care
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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