title: Implementation of an enhanced safety-engineered sharp device oversight and bloodborne pathogen protection program at a large academic medical center.
abstract: OBJECTIVE
  Exposure of healthcare personnel to bloodborne pathogens (BBPs) can be prevented in part by using safety-engineered sharp devices (SESDs) and other safe practices, such as double gloving. In some instances, however, safer devices and practices cannot be utilized because of procedural factors or the lack of a manufactured safety device for the specific clinical use. In these situations, a standardized system to examine requests for waiver from expected practices is necessary.
  
  
  METHODS
  Before-after program analysis.
  
  
  METHODS
  Large academic medical center.
  
  
  METHODS
  Vanderbilt University Medical Center developed a formalized system for an improved waiver process, including an online submission and tracking site, and standards surrounding implementation of core safe practices. The program's impact on sharp device injuries and utilization of double gloving and blunt sutures was examined.
  
  
  RESULTS
  Following implementation of the enhanced program, there was an increase in the amount of undergloves and blunt sutures purchased for surgical procedures, suggesting larger utilization of these practices. The rate of sharp device injuries of all at-risk employees decreased from 2.32% to 2.12%, but this decline was not statistically significant (P = .14). The proportion of reported injuries that were deemed preventable significantly decreased from 72.7% (386/531) before implementation to 63.9% (334/523; P = .002) after implementation of the enhanced program.
  
  
  CONCLUSIONS
  An enhanced BBP protection program was successful at providing guidance to increase safe practices and at improving the management of SESD waiver requests and was associated with a reduction in preventable sharp device injuries.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, and Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Talbot
authors.forename: Deede
authors.initials: D
authors.lastname: Wang
authors.forename: Melanie
authors.initials: M
authors.lastname: Swift
authors.forename: Paul
authors.initials: P
authors.lastname: St Jacques
authors.forename: Susan
authors.initials: S
authors.lastname: Johnson
authors.forename: Vicki
authors.initials: V
authors.lastname: Brinsko
authors.forename: Valerie
authors.initials: V
authors.lastname: Thayer
authors.forename: Teresa
authors.initials: T
authors.lastname: Dail
authors.forename: Nancye
authors.initials: N
authors.lastname: Feistritzer
authors.forename: Shea
authors.initials: S
authors.lastname: Polancich
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D017848:Blood-Borne Pathogens; D004867:Equipment Design; D017575:Gloves, Protective; D017408:Guidelines as Topic; D006801:Humans; D016602:Needlestick Injuries / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control*; D016272:Occupational Health / Q000592:standards*; D060051:Occupational Injuries / Q000517:prevention & control*; D016134:Organizational Policy; D016730:Program Development; D013514:Surgical Procedures, Operative; D013537:Sutures