'Myths' could leave nurses in danger of sharps injuries
Nurses will remain at risk of unnecessary sharps injuries because half of trusts are unlikely to switch to safer needles, despite new European legislation.
Myths around the cost of safer devices will hinder their introduction in many cases, according to documents seen by Nursing Times.
European ministers ruled last week that risk assessments should be done in all areas where sharps are used and safety devices, such as retractable needles, introduced where a risk of injury is found.
A similar law was adopted in the US almost a decade ago and led to hospitals universally adopting safety syringes and needleless devices. An NHS trial of safety-only needles at University Hospitals Birmingham Foundation Trust led to a 70 per cent reduction in needlestick injuries over four years.
Campaigners now hope the EU law – which must be adopted by the UK within three years – will have a similar effect across the NHS.
Latest figures from NHS Supply Chain suggest that just 9 per cent of syringes and needles used in the NHS have safety devices to prevent nurse injuries.
But calculations made in 2008 by the Health and Safety Executive, seen by Nursing Times, show the agency expects only a 40 to 50 per cent of trusts to switch to safety devises over ten years.
The HSE calculate that will lead to only half of the estimated total 63,750 preventable needle stick injuries a year being prevented. That would be the equivalent of a 38 per cent reduction in injuries, compared with 70 per cent in the Birmingham study.
It says the lack of urgency is down to a “perception” that safety devices are very expensive, which would in turn influence those undertaking risk assessments to decide that costs outweigh the benefits of switching.
That perception is not borne out by the HSEs’ calculation however, which estimate that in 2008 the average extra cost of a safety device was just 5p more than a standard device. According to HSE figures, that would entail an extra cost to the NHS of just £6.2m a year if all NHS trusts switched to safety devices.
South London and the Maudsley foundation trust deputy nurse director Jane Sayer told Nursing Times her trust had decided four years ago to use only retractable safety needles.
She said: “They were more expensive, but it’s a risk issue so the decision was very clear: we were going to use retractables.”
But Royal Devon and Exeter foundation trust senior infection prevention and control nurse Judy Potter said the trust “hardly use” retractable needles because “they are not as sharp, [so] the patients find them much more uncomfortable”.
The directive sets out in EU law requirements for risk assessment, prevention and treatment of sharps injuries among healthcare workers.
Senior healthcare litigation solicitor at Hempsons Solicitors Miriam Farley told Nursing Times much of the directive was already implicit in UK law and regulation, but there was a perception EU law was needed to make NHS employers “take more action.”
She said the most significant change for the UK was the “immediate” ban on “re-capping” or re-sheathing of needles.
Although directors of nursing say this is already “a no-no”, re-sheathing accounts for up to 30 per cent of reported needle stick injuries a year.
The new law puts the onus on both employers and employees to completely eliminate re-sheathing. For directors of nursing that means ensuring adequate training, as well as providing sufficient sharps bins to remove the need for needles to be re-sheathed when being carried to a distant bin, she said.
But Ms Farley warned the law’s new “positive duty” on nurses to take responsibility for their own safety could act to limit potential claims against their employer, especially if they received an injury while re-sheathing.
Even if a nurse claimed he or she was “forced” to re-sheath a needle due to a lack of sharps bins, the courts may want to see evidence that the nurse had fulfilled their duty to alert the employer to the situation, Ms Farley said.