title: Barriers to the Adoption of Safety-Engineered Needles Following a Regulatory Standard: Lessons Learned from Three Acute Care Hospitals.
abstract: BACKGROUND
  A number of jurisdictions have introduced regulation to accelerate the adoption of safety-engineered needles (SENs). This study examined the transition to SENs in three acute care hospitals prior to and following the implementation of a regulatory standard in Ontario. This paper focuses on the ongoing barriers to the prevention of needlestick injuries among healthcare workers.
  
  
  METHODS
  Information from document review and 30 informant interviews were used to prepare three case studies detailing each organization's implementation activities and outcomes.
  
  
  RESULTS
  All three hospitals responded to the regulatory requirements with integrity and needlestick injuries declined. However, needlestick injuries continued to occur during the activation of safety devices, during procedures and during instrument disposal. The study documented substantial barriers to further progress in needlestick injury prevention.
  
  
  CONCLUSIONS
  Healthcare organizations should focus on understanding their site-specific challenges that contribute to ongoing injury risk to better understand issues related to product limitations, practice constraints and the work environment.
authors.affiliation: Doctoral Student, Institute for Work and Health Toronto, ON.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chambers
authors.affiliation: President and Senior Scientist, Institute for Work and Health Professor, Dalla Lana School of Public Health, University of Toronto Toronto, ON.
authors.forename: Cameron A
authors.initials: CA
authors.lastname: Mustard
authors.affiliation: Professor, Dalla Lana School of Public Health Director, Department of Medicine, University of Toronto Chief Physician, St. Michael's Hospital, Toronto, ON.
authors.forename: D Linn
authors.initials: DL
authors.lastname: Holness
authors.affiliation: Director of Nursing, University Health Network, Assistant Professor, Dalla Lana School of Public Health, University of Toronto Toronto, ON.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Nichol
authors.affiliation: Scientist, Institute for Work and Health, Toronto, ON.
authors.forename: F Curtis
authors.initials: FC
authors.lastname: Breslin
mesh_terms: D000062:Accidents, Occupational / Q000331:legislation & jurisprudence / Q000517:prevention & control* / Q000639:trends; D001291:Attitude of Health Personnel; D004867:Equipment Design; D004865:Equipment and Supplies, Hospital / Q000592:standards; D006284:Health Plan Implementation; D006764:Hospitals, Community / Q000458:organization & administration; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D009339:Needles / Q000592:standards*; D016602:Needlestick Injuries / Q000517:prevention & control*; D016272:Occupational Health / Q000331:legislation & jurisprudence; D009864:Ontario; D019982:Organizational Case Studies; D010564:Personnel, Hospital / Q000193:education / Q000523:psychology* / Q000592:standards; D036301:Qualitative Research; D018570:Risk Assessment; D013997:Time Factors