Book Description

Each year, 385,000 needlesticks and other sharps-related injuries are sustained by hospital-based healthcare workers in U.S. (CDC, 2015). Out of the overall sharps injuries, approximately 67% are caused by needlestick devices ("CDC: Stop Sticks, Sharps Injuries," 2013). Numerous pathogens can be transmitted through needlestick injuries, but the three most common pathogens are Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus. There are processes in place to reduce needlestick injuries such as work-practice control, engineering control, personal protective clothing and equipment, employee training, etc., but they have not eliminated needlestick injuries. The purpose of this thesis is to investigate the systematic causes of needlestick injuries in Massachusetts hospitals. System thinking process is used to define the needlestick system, interaction between stakeholders and see how injuries affect the needlestick system. System Dynamics model is also used to illustrate the pathway of the root causes of needlestick injuries. By using system thinking, current literature, stakeholder interviews, and knowledge from shadowing at one of the reputable hospitals in Boston, a systematic solution is proposed. The proposed solution addresses the root causes of needlestick injuries: professional pressure, high patient load/long hours, and patient-centric safety culture. The proposed solution also includes methods to address underreporting. Professional pressure and high patient load is addressed by creating programs that focus on improving self-care and reducing level of fatigue for the healthcare workers. In order to change the patient-centric safety culture, to patients and healthcare workers focused safety culture, the current prevention methods are reiterated. Furthermore, programs to create awareness of needlestick injuries, which forces doctors and nurses to consciously think about needlestick injury safety is proposed. An example is given of sharps injury prevention in surgeon's "time-out" checklist, similar to what is used at the Boston hospital. Finally, to address underreporting, programs to provide quick and easy reporting process are proposed for the healthcare workers. An important complement to the reporting system is a safety culture, where the healthcare workers do not feel fear of reporting due to repercussion on their jobs. A holistic solution is needed for a complex problem such as needlestick injuries. Only with a systematic solution that focuses on all of the root causes of needlestick injuries can they truly be reduced to a negligible amount.