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Three ways to prevent an exposure incident

Feb. 21, 2011
Needlesticks and other percutaneous injuries can cause exposure to blood or other potentially infectious materials. Leslie Canham, CDA, RDA, talks about the three ways to prevent an exposure incident: using engineering controls, using needle recapping devices, and working practice controls.
By Leslie Canham, CDA, RDANeedlesticks and other percutaneous injuries can cause exposure to blood or other potentially infectious materials. A percutaneous injury occurs when a needle, sharps instrument, or other device penetrates the skin. Careful handling of sharps can prevent an exposure incident. Three ways to prevent an exposure incident include using engineering controls, using needle recapping devices, and working practice controls.Engineering controlsEngineering controls isolate or remove the bloodborne pathogen hazards from the workplace. Safety syringes are a type of engineering control designed to eliminate recapping and removing the needle after use. One brand of safety syringe has a sliding plastic tube that covers the needle so it does not need to be recapped. After the procedure, the syringe tube snaps into a locked position and the entire syringe and needle are disposed of in the sharps container. The handle is reusable and can be sterilized.
Sharps containers are also considered an engineering control. Be sure to observe the “full” line on sharps containers. An overfilled sharps container can prevent additional sharps from falling free into the container. If one were to push down a sharps item into an already full container, it might cause an injury. When sharps reach the full line, put the cap on the container and remove it from service. Arrange for pickup, mail away, or dispose according to your state and local regulations.Needle-recapping devicesNeedle-recapping devices come in a variety of styles.
Metal or plastic recapping devices must be sterilized or disinfected between patients. One company designed a needle-recapping device that is a square piece of lightweight cardboard with a small hole in the center. The needle cap is placed in the hole. When the cap is removed from the needle, the cardboard holds it at an angle so it can be easily recapped. After the needle is recapped, the cardboard square remains on the syringe. When it is time to discard the needle, the cardboard square is used to transfer the needle to the sharps container. The cardboard square can then be disposed of, eliminating the need to sterilize or disinfect another item. Work practice controlsWork practice controls reduce the likelihood of exposure by altering the manner in which a task is performed. It would be easy but dangerous to recap a syringe in the same manner one would recap an ink pen. Using a “one-handed” scoop technique is much safer. This is accomplished by using the needle to scoop up the cap. There is still a chance that the needle could bend and penetrate the cap. To prevent possible injury, use a one-handed scoop technique entirely with one hand.
Other work practice controls include using instruments instead of fingers to retract tissue during suturing or injections, announcing instrument passes, and keeping sharp ends pointed away from dental workers.OSHA prohibits recapping needles with both hands. Engineering controls, needle-recapping devices, and work practice controls can greatly reduce the chances of a needlestick or other sharps injury. The OSHA needlestick safety and prevention plan requires clinical employees to document their evaluation of safe sharps devices as they become available. Ask your dental dealer how to obtain safer sharps devices and safety syringes. You can use your evaluation as an opportunity to refresh your skills on sharps safety. If you would like a complimentary copy of a sharps evaluation form, send your request by e-mail to [email protected].Author bioLeslie Canham is a dental speaker and consultant specializing in infection control and OSHA compliance. She has more than 36 years of experience in dentistry. Canham is the founder of Leslie Canham Seminars, providing in-office training, mock inspections, consulting, and online seminars and webinars to help the dental team navigate state and federal regulations. Reach Canham at (888) 853-7543 or Leslie Canham.