My hospital has been slow to implement safer needle devices, while another hospital at which I work per diem has safety devices in almost all areas. What are my rights when the new law is violated?
The Needlestick Safety and Prevention Act (P.L. 106-430), which became law on November 6, 2000, provides important protections for health care workers.
ASSESSING COMPLIANCE
To see if your facility is following the law, review the following checklist for compliance:
* Does a written exposure control program (ECP) exist?
* Has a hard copy of the ECP been made available to employees or their representatives within 15 working days of a request for one?
* Is the ECP reviewed and updated annually or more frequently whenever new or modified procedures are adopted or whenever employee positions are revised in such a way that creates new potential exposures?
* Does the annual review of the ECP include a review of the most recent technological advances?
* Does the review of safety devices include the involvement of frontline health care workers (nonmanagerial employees responsible for direct patient care), which is required, in device evaluation and selection, with evidence of this participation documented in the ECP?
* Are needleless or shielded-needle IV line access products provided?
* Are safer needles and other sharps with integrated safety features being used when medically appropriate? They should be available in syringes, blood collection devices, IV access products, lancets, and blunt suture needles.
* Are purchasing decisions based on the safest and most effective option as opposed to the least expensive?
* Have frontline health care workers received interactive training on the use of safer devices from a knowledgeable person; been informed of the location of the ECP and the procedures to follow if an exposure occurs; and been given access within two hours to postexposure follow-up that conforms to the Centers for Disease Control and Prevention (CDC) guidelines for testing and prophylaxis? (See this month's Health and Safety column, page 104.)
* Is there a sharps injury log updated regularly with the details of all needlestick injuries, including device brand and type?
FILING A COMPLAINT
A complaint is notice of an alleged uncontrolled occupational hazard or a violation of the Occupational Safety and Health (OSH) Act, given by a past or present employee or an employee representative (such as a union). It's your responsibility to report the hazard to a supervisor and, if it's not corrected, to contact the your local or state OSHA office. Fill out OSHA's official complaint form, including, if possible, the specific violation of the OSH Act. OSHA recommends including the following information:
* the number of employees who work at the site and how many are at risk for exposure to the hazard
* details regarding the status of compliance, such as types of sharps used in all areas of the employment setting
* the units on which the use of safety devices hasn't been implemented
* the number of needlestick injuries recorded in available needlestick logs
* whether or not frontline staff nurses and other health care workers were involved in the evaluation and selection of the safety devices
* data documenting the trials of safety devices and evidence regarding the decision to use the particular product
It's against the law for an employer to discriminate against an employee for filing an OSHA complaint. Consult your local OSHA office or your state nurses association for assistance.
RESOURCES
The Occupational Safety and Health Administration page on how to file a complaint: http://www.osha.gov/as/opa/worker/complain.html
ANA's Safe Needles Save Lives Web page: http://www.nursingworld.org/needlestick/ncompln.htm