This research aims to analyze data on sharps and needlestick injuries at the Massachusetts Eye and Ear Infirmary in Boston to identify which medical devices are causing the most injuries and how to prevent them. The objectives are to determine which procedures have the highest injury rates and riskiest motions, evaluate the safest tools, develop safer strategies, and maintain an injury database. Data on injuries will be analyzed using statistical methods to identify risk factors and compare results to the Massachusetts Department of Public Health. The goal is to create a safer work environment and more efficient care for patients.

1. Michael Boyer
Epidemiology
October27, 2014
Reviewof Needle Stick andSharpsInjuriesatthe MEE of Boston
Introduction:
Hospitalsare traditionallythoughtof asa place of healing,wherethe sickcome toget better
and the weakregaintheirstrength.Formostof usthisis true,butfor those workinginthese facilities
the hospital canbecome a dangerousenvironment.Mostdoctors,nursesandanyone whohelpsona
medical teamworklongandgruelinghours,potentiallyovernightandthroughbreaksintime of urgent
care. Theyare constantlyexposedtothose whoare sickand to manythat do not wishtobe there.These
highpayingjobscome withlarge amountsof stress.Like withanyjob,workinjuresdooccur, however
these injuriescanbe a matter of life ordeath.One of the mostcommoninjuriestohospital workers
involvedinproceduresare needle stickandsharpsinjuries (OSHA).These injuriesoccurwhenaneedle
or sharp tool puncturesthe skin.Infectiousdiseases,includingall bloodborne pathogens,canbe
transmittedfromthisinjury (OSHA). Inmanycasesthe injuryismore painful thanlife threating,but
there isthe rare occurrence of beingexposedtodangerslike HIV orEbola.Injuriesduringaprocedure
can comprise itsendresult, potentiallycostingapatienttheirlife. Byexaminingandanalyzingdata
collectedfromthe staff atthe MassachusettsEye andEar InfirmaryinBoston,Ihope to better
understandandhelppreventsharpsandneedlestickinjuries.Iwill be investigatingwhichtoolscause
the most injuries,whattype of proceduresthese injuriesoccurduringandtype of medical attentionthat
had to be soughtby the injuredemployee.Datacouldbe splitandviewedspecificallyforsharpsor
needle stickinjuriesonly.I will alsoattempttopinpointwhenthe injuriesoccur;during/afterdisposal,
afteruse before disposal,orduringuse tosee whetheritisthe tool itself thatisdangeror if itcouldbe
the motionor use of the tool.Ourmain goal will be tosee whichdevicesare more orlessriskyand
whetherthere isasaferalternative.If there isnota saferalternative,more trainingmaybe suggestedor
the implementationof anewpolicywhichattemptstoalleviatethe stressduringprocedures.
Annually,anestimated384,000 sharpsor needle stickinjuriesinvolvinghealthcare personnel
occur (NORA).These estimatesare consideredtobe verylow since the collectionof thisinformationcan
oftenbe forgottenaboutor notevenreported.Manydoctorsmay notreport a minorinjurysince they
may lose time atwork,but inreality theymayhave contracteda deadlybloodborne pathogens.
Althoughthere isavaccine for the bloodborne pathogenHepatitisBVirus,there remainsnone forHIV
or the HepatitisCVirus(NORA). Hospitalsoftenunderreportthesetypesof injuriesbecause theycanbe
costlywhentryingtoget accreditationorwhenreportinginjuriesforinsurance purposes. CDC
sponsoredmeetingshave realizedthata soundstrategyinvolvingimprovedsurveillance, extended
educationandtraining,andan increase use of toolswithsharpsinjurypreventionmechanismswill help
decrease the numberof injuriestohealthcare personnel(NORA).
Broad Goal:

2. The broad goal of thisresearchisto helpcreate a saferworking environmentforhospital
workers,thusinreturncreatinga more efficientenvironmentforthe patient.
Research Question:
What devicesare contributingtothe most sharpsinjures atthe MassachusettsEye and Ear
InfirmaryinBoston andwhat can be done topreventthem?
Objectives:
1.) To create denominatorstoasseswhichprocedureshave the highestnumberof injuries,
highestinjuryrate,whichmotionhasthe mostnumberof injuries,andwhichmotionhas
the highestinjuryrate.
2.) To evaluate whichtool is the mostdangerousandsee if a saferalternative isavailable.
3.) To developandimplementnew,saferstrategieswhenhandlingpotentiallydangeroustools.
4.) To maintaina database forfuture studiesandreference.
5.) Compare data withthatcollectedbythe MassachusettsDepartmentof PublicHealth.
Methods:
The data set that isgoingto be reviewedhasbeencollectedbythe Employee HealthandInfection
Control Departmentsatthe MassachusettsEye and Ear InfirmaryinBoston.Once I receive the data,I
may be able to workon itfrom anydesiredlocation;if not myworkcite wouldbe locatedinthe
InfectionControl Departmentatthe MEEI.
The populationformystudywill be anyemployeeinuredfromasharpor needle stickwhile workingat
the MassachusettsEye and Ear Infirmaryduringthe time datawascollected.The injury,ratherthan
injuredwill be examined.The onlymedical historythatwill be neededwill be toexamine whattype of
follow-uptreatmentoccurredafterthe injury.
1.) Anyrate or count of injurieswill be evaluatedusingstatisticalanalysesof the dataset.
Denominatorswillbe createdbasedonwhichvariablesare availablefromthe dataset.SPSS
will be usedtorun all analyses.
2.) Statistical analysiswill helpshow whichtool isthe mostdangerous,similartothe first
objective.Tosee if asaferalternative isavailable,areview of currenttool modelsandsafety
featureswill be completed.
3.) To developandimplementsaferstrategies,oldguidelinesmustbe reviewedandupdatedto
helpprotecttoday’sworker

3. 4.) One central database will be createdandbacked-uptoensure thatfuture studiescan
reference it.
5.) Data will thenbe comparedwith informationcollectedbythe MassachusettsDepartment of
PublicHealth
References:
UnitedStatesOf America. U.S.Departmentof Labor. Occupational Safety&Health
Administration. HealthcareWideHazards:Needlestick/SharpsInjuries.N.p.,n.d.Web.19 Oct.
2014. https://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html
UnitedStatesof America.NORA.DEPARTMENTOF HEALTH ANDHUMAN SERVICES.
Identificationof ResearchOpportunitiesforthe NextDecade of NORA.N.p.:n.p.,n.d.CDC.CDC
& NIOSH,Aug.2009. Web.05 Dec. 2014. <http://www.cdc.gov/niosh/docs/2009-
139/pdfs/2009-139.pdf>.