Opening Sharps Containers

[MaxNurse]

Is it against OSHA standards to open used sharps containers? Where I work the needle count is closely watched, as it is a very high security job. A lost needle could be detrimental to all staff. To help deter this the DON has decided when a needle leaves the medication room, taken to the units and used, dropped into a small portable sharps container...then it is to be brought back to the med room, where at that time 2 nurses are to open the sharps, account for the used needles and then they are to be dropped into a large sharps container. To my co-workers and myself we feel this is dangerous as well as being against OSHA standards.

Any one have any idea?

Thanks

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~~Dee~~

[Sharon]

Weighing in as an occupational health nurse who has worked with law enforcement. You supervisor/DON is not only violating OSHA standards but is also demonstrating a reckless disregard for employee safety. If an employer and or supervisor is determined by the courts to be reckless then they have almost no defense under workers compensation act and they can be personally sued.

What to do:

1. Put your complaint in writing to the DON. Include a date that you would like a response by. It helps if you can provide one or two engineering control suggestions in your memo. An example of an engineering control is a self re-sheathing needle or needless system.

2. If the procedure does not change then you should file a complaint with OSHA.

Here is a "What if Scenario" to consider. You do not report the situation and a guard makes an anonymous complaint to the Board of Nursing or OSHA, citing an episode that occurred when you removed dirty needles from a sharp container. How do you intend to defend an unsafe practice with the Board of Nursing?

[dianee]

Wow!

Someone at your hospitl must be sniffing the nitous oxide! It is absolutely unthinkable that you have to count used needles. Don't waste even one second going to your adminstration about this one. Call OSHA immediately. They will investigate and immeidiately issue an injunction to cease and desist this practice. As the former safety and infection control nurse of a hospital, I can tell you OSHA will act with deadly speed, (ot your hospital will be fined BIG TIME) and your problem will be over.

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Diane

[hmt]

No matter who or what, never open sharps containers EVER!! Have this institution PURCHASE a needle counter. If this place demands needles to be counted then there should be a needle counter on the unit. A mini Pyxis, about 2 1/2 square ft machine could count needles as you open and close the locking drawers. Then they are automatically dropped into a box, and totaled by the Pyxis at the end of each shift/or day. Then the directors involve themselves personally in proper disposal when the container is full. I would try to contact PYXIS, they have different sizes of drawers. They should be able to load a program for counting needles as they are disposed of. Good luck.

[hmt]

Another idea: What should be counted is not the dirty needles at change of shift, but un used needles. There could be a shift to shift un used needle/syringe count (just don't have gobs of needles to count...leave majority of unused ones in the directors office). Then you may not need the PYXIS. You still would have to enter a code or name for the PYXIS, so surely you can just have a flow sheet to chart shift to shift un used needle counts. This can be documented on a similar flowsheet with all the injections for the shift. So there's your used needle count. It's your life.

[MaxNurse]

hmt

At the beginning of every shift we count all sharps (unused), then when a sharps, such as a insulin needle or vaccutainer needle is needed we sign them out. We sign a dropped sheet as it is dropped into a sharps container. This has worked well, until the count came up wrong at the end of the shift. A nurse had 4 labs, counted out 8 vaccu-needles went to the housing units to do labs, when she returned she stated she had 3 successful sticks (used 3 needles) and one inmated had refused labs to be drawn. She should have returned 5 needles, but only had 4 in the lab tray she had taken to the units. Later an inmate returned the un-used needle to the unit sgt, which in turn took it to his supervisor. Needless to say the medical dept caught hell over it! What had happened in this case was some how the un-used needle had fallen out and the nurse didn't know it. But this is what started the whole thing about counting used needles as well as un-used (which we already had been counting). This is the only time that I know a needle has ever came up missing in the three yrs I've worked there, but it's all it took for everyone to get a little crazy. I like the needle counter idea, I've proposed it to my DON, but have not heard any word on it. I'm giving her a week to check everything out, and if things don't change I will contact OSHA on this. I may be fired for whistle blowing, but if it saves a life then it will be worth it. Plus if that happens I smell a law suit. I'm not one to sue, but if I'm fired for reporting a dangerous acitivity I feel I have every right.

Thanks for your input.

[ratchit]

There is a fairly new kind of syringe that comes attached to a needle. After the needle is used a sleeve slides over the needle and locks in place. You could run with it and not get stuck. Maybe you could switch to these making dirty sharp count safer? Or could you drop them into clear glass containers with a limit of 5 or 10 each so they could be visually counted without touching them?

I agree with you, though- the need for safety is important but how insulting of them to think you'd give an inmate a sharp!!

[MaxNurse]

ratchit:

We used the safety needles before for injections, but then they switched back to the capped ones, due to cost. we use a lot of vaccu-needles for labs, we average about 10 labs per night. These too are to be counted. the clear sharp cantainers were suggested, guess what, price came into play again. I guess they are determined to cut cost and go against safety standards. That's until they're busted by OSHA. Unfortunately it seems managment isn't interested in hearing any suggestions from the nurses. But the nurses are coming together to ban against this.

[Sharon]

MaxNurse,

I know you have heard alot about this issue. But, I thought I would pass on this posting from the AAOHN Discussion Board.

Posted by Kae Livsey on March 06, 19100 at 13:15:36:

The purpose of message is to call your attention to a Request for Applications (RFA) from the National Institute for Occupational Safety and Health (NIOSH), which is posted on the webpage of the National Institutes of Health.

http://grants.nih.gov/grants/guide/rfa-files/RFA-OH-00-004.html

Letters of Intent in response to this RFA are due 3/28/00.

Applications are due 4/27/00.

The title of the RFA is "Incidence of Needlestick and Sharps Injuries and Medical Safety Device Availability/Use among Non-Hospital Health Care Workers." The focus will be on health care workers employed in

the United States.

Information on a preapplication teleconference on 3/14/00 is

contained in the RFA.

Please pass this message on to other interested potential

applicants.

Address questions to:

Michael Galvin, PhD

Health Scientist

National Institute for Occupational Safety and Health (NIOSH)

Centers for Disease Control and Prevention

404/639-1533

[Blue11RN]

If the mangement is so crazy as to want you to count syringes and put the nurses at risk, I guess they should do it themselves. Sounds like a mangement job to me! Watch how fast that dumb rule would change, huh?

[mcrow]

It is a scary thing to get a needlestick. And in a correctional facility? I can only imagine. It is not worth the risk to go through dirty needles. Please for your own sake keep firm on this issue. It is a violation of OSHA standards for a very good reason. You are that reason. Take care of yourself.