The knock-on effect of sharps injuries
When we think of the impact of sharps injuries, we usually think about the immediate effect of the injury on the surgeon or nurse who has sustained it, writes John Timmons, Medical Affairs and Safety Director at Mölnlycke.
It’s natural: we know that an overwhelming majority of healthcare professionals (HCPs) have had a close encounter with a serious risk to their health and safety, including through sharps or needlestick injuries.[i] But these all-too-common incidents have a knock-on effect in the healthcare system, and as we observe Sharps Awareness Month, there is no better time than now to take action.
One profession that understands and experiences the scale of sharps and needlestick injuries first-hand is Occupational Health (OH). OH professionals act as the first point of contact when a HCP sustains an injury, and provide the essential support needed to ensure that they not only receive the correct treatment, but that sharps injuries are properly reported.
In November 2020, Mölnlycke commissioned a survey of 251 OH professionals to understand their perceptions of the impact of sharps injuries on clinicians and hospitals.[ii] OH professionals were surveyed from across the UK, both in the NHS and the private sector, they all had responsibility for operating theatre staff as part of their job description.
The results of the survey highlighted that sharps injuries are prominent in hospital settings. In the case of sharps injuries, over three quarters (76 per cent ) of OH professionals receive referrals for this at least once a month. Shockingly, 15 per cent of OH professionals received referrals for sharps injuries 2-3 times a week.
There are a number of serious consequences to the scale of this problem, which in turn have a knock-on effect on other areas of care. Over a quarter of those surveyed (27 per cent) stated that cancelled or delayed operations is one of the major consequences of sharps injuries. This can cause disruption in any healthcare system, but during the pandemic, it’s even more of a problem. NHS England figures released last week show over 2 million people have been waiting longer than the 18-week target for surgery.[iii] Furthermore, many of the treatments and operations cancelled are for cancer,[iv] heart and circulatory disease[v] or other life-altering conditions. By working to reduce the amount of sharps injuries that occur the chances of restarting these vital surgeries can be maximised.
Our OH survey illustrates the mental and emotional impact that these injuries in the operating theatre can have on clinicians too. Over a quarter (27 per cent) of occupational health professionals identified the emotional distress of the clinician as the most significant impact of sharps injuries – an unacceptable statistic when you consider the role clinicians play in keeping us safe every day. As well as being exposed to blood-borne diseases such as HIV and Hepatitis C, sharps and needlestick injuries can carry a psychological impact that results in clinicians and HCPs requiring wellbeing support, and in some cases, time off work.
It is no surprise that the same proportion of OH professionals – 27 per cent – identified delays and cancellations to surgeries as the biggest impact of sharps injuries, illustrating the repercussions at an institutional level as well as an individual level. It seems that these are not only the most vital concerns, but they are perhaps interlinked.
There is no doubt that more work needs to be done to prevent sharps injuries. Only 30 per cent of survey respondents said that their organisation has a clear referral pathway for HCPs experiencing sharp injuries that could not be improved. Furthermore, respondents placed a great emphasis on the fact that renewed national and local guidelines need to be put in place to improve sharps prevention. It is time for a concerted effort, both at trust and national level, to implement more rigorous guidelines to prevent sharps injuries, as well as to provide HCPs with the high-quality protective equipment they deserve to keep them safe.
Now has never been a better time to do so. Our survey found that 55 per cent of OH professionals agreed that reporting of sharp injuries has increased as a result of the Covid-19 pandemic. However, this may only be the tip of the iceberg, as we also found that nearly as many people – 51 per cent of respondents – agreed that under-reporting of sharp injuries has increased as a result of the Covid-19 pandemic, suggesting that the true number may be far greater. It’s unclear why this might be the case, but a desire to avoid delays and costs may lie behind it.
However, increasing awareness around sharps prevention, and acting to reduce the number of injuries incurred, can in fact help hospitals as they recover from the pandemic. Given that 21 per cent of respondents said that the most significant impact of sharp injuries on clinicians or the hospital is the financial cost to the hospital, introducing measures such as double-gloving in the operating theatre will not only offer protection to clinicians, but could also reduce the financial burden on the hospital.
As we look to 2021, there may be a further impetus for raising awareness around this issue: the UK’s departure from the EU. With our most up-to-date legislation, the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, derived from EU law, there is an opportunity for the UK to renew its commitment to sharps prevention, and set an example to other countries by driving world-leading regulations in this field. As the country seeks to move forward both in its recovery from Covid-19 and define itself in the implementation of world-leading regulation, there has never been a better time to act to stop sharps injuries.
[i] Mölnlycke. 2019. More than 9 in 10 UK surgeons encounter a needlestick injury. https://www.molnlycke.co.uk/news-events/news-archive/SERMO-Survey-UK/.
[ii] Mölnlycke. 2020. Occupational Health Survey. Data on file.
[iii] C Lamb. 2020. The silent cost of the coronavirus: NHS cancer delays, cancelled operations and a bleak winter ahead. Available at: https://www.thetimes.co.uk/article/the-silent-cost-of-the-coronavirus-nhs-cancer-delays-cancelled-operations-and-a-bleak-winter-ahead-jnjkfvfbt
[iv] S Lintern. 2020. NHS hospital forced to postpone cancer operations as Covid spreads on wards. Available at: https://www.independent.co.uk/news/health/coronavirus-nottingham-cancer-operations-cancelled-outbreaks-b1373423.html
[v] British Heart Foundation. Appointment and surgery delays during coronavirus. Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/delays-during-coronavirus