Why are needlesticks and other sharps injuries occurring in home healthcare?
Methods. Sharps procurement, use, and disposal were assessed via 25 in-depth interviews with a wide range of sharps safety stakeholders including HHC agency clinicians and managers, diabetes educators, devices manufacturers, insurers, sharps disposal representatives, and pharmacists. Interview transcripts, as well as documents related to sharps policies and practices, were coded using NVivo software to identify sharps-related themes. The themes were integrated in a map showing how sharps enter and leave a home and the location of key decision-makers in the HHC system.
Results. Sharps enter the HHC environment via multiple pathways that may be outside the healthcare system and are not coordinated by the HHC worker or any other decision-maker. Sharps with injury prevention features are more expensive and sometimes harder to use than conventional sharps. Unlike in hospitals, sharps are frequently re-used by HHC patients and left around the home, increasing risks to HHC workers. Free-of-charge sharps disposal containers, sharps collection sites for consumers, and safety training for HHC workers and patients can be successful interventions.
Conclusions. Sharps use in HHC needs coordination. Interventions are needed to prevent injuries. Qualitative methods are effective in investigating how and why SI occur.
Learning Areas:Occupational health and safety
Systems thinking models (conceptual and theoretical models), applications related to public health
Discuss the importance of qualitative methods in occupational safety and health research, in particular in investigating why and how occupational injuries occur; demonstrate how sharps medical devices (sharps) enter and leave a home; identify key sharps safety decision-makers in the home healthcare (HHC) system; and describe promising sharps injury prevention policies and practices implemented by the HHC industry.
Keyword(s): Home Care, Injury Prevention
Qualified on the content I am responsible for because: Since 2004, I've been a co-investigator in two federally (NIOSH) funded grants on safety and health among home healthcare and home care workers as well as sharps injury prevention in HHC. Currently, I'm a co-principal of our NIOSH-funded grant. I lead the Project's qualitative research activities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.