Slowly but surely, safety legislation is coming to reduce needlesticks
Slowly but surely, safety legislation is coming to reduce needlesticks
States follow CA in introducing safe-needle bills
It didn’t take long for the states to play follow the leader. After California passed legislation requiring health care providers to use safety measures such as needleless devices and safety catheters, no fewer than 17 other states followed suit. According to Steve Trossman, manager of campaign communications with the Service Employees International Union (SEIU) in Washington, DC, the steady flow of state bills is no surprise.
"More than 250 such devices have been approved by the FDA," he says. "The CDC [Centers for Disease Control and Prevention] says that these devices reduce needlesticks by 75%."
The 18 states with safe-needle legislation were already introduced, and each bill’s status, according to Trossman, is:
1. Arkansas — recently introduced.
2. California — passed (for more on California’s groundbreaking legislation, see May 1999 Home Infusion Therapy Management).
3. Connecticut — introduced.
4. District of Columbia — introduced.
5. Florida — introduced, but stalled.
6. Illinois — recently passed the House unanimously.
7. Iowa — introduced.
8. Massachusetts — introduced.
9. Maryland — a study bill passed requiring the state and outside groups to study the issue.
10. Michigan — introduced.
11. New Hampshire — According to Trossman, the SEIU is in the process of petitioning the state labor commission for an administrative rule change on OSHA that would require safe needles.
12. New Jersey — passed.
13. New York — a bill may be introduced shortly.
14. Ohio — at press time, a bill awaited introduction.
15. Oregon — introduced.
16. Pennsylvania — legislation is being drafted.
17. Tennessee — legislation passed, but does not include an implementation date.
18. Texas — introduced.
Trossman notes that most of the bills are similar to California’s, but there is no telling how much they may change when and if they become law. Also, he says that the SEIU is currently working with members of Congress to introduce a federal bill.
"We are trying to line up sponsors for bipartisan support, so this is something that could be introduced any time."
Pros and cons?
The reason for such legislation is obvious: protecting health care workers from suffering a needlestick injury that could lead to HIV, hepatitis C or hepatitis B. But there are several reasons that legislation is the necessary step to require the use of such safety devices. First is the cost.
"The devices are very common, but they are more expensive," says Trossman.
Lynn Hadaway, MEd, RNC, CRNI, principal of Hadaway and Associates, an infusion therapy consulting firm in Milner, GA, says the expense argument holds water.
"I can understand the cost," she says. "When you look at the low-end cost of a conventional catheter, 70 to 75 cents is the lowest contract, high-volume price out there. When compared to the cost of the safety devices at $1.75, that’s a significant increase in cost. But when you look at the risk your health care workers are taking, you have to put that cost into perspective."
Trossman adds that as safety devices become more widespread, price should become less of a factor.
"We believe that the price will come down as more people begin to use them," he predicts. Even if they don’t, though, they will still save you money over the long haul.
"When you factor in the cost of testing everybody who gets stuck and must go through a rigorous testing regimen and go on the HIV cocktail for six months, the cost is not just between Needle A and Needle B," he adds.
According to Trossman, all the bills introduced or passed allow for the use of standard devices where the safe needle technology is not available or as effective. But Hadaway says that should not be a concern.
"We’ve got almost all the bases covered: IV catheters, subcutaneous injections, connections on the IV lines, blood drawing and blood sampling devices, protected butterflies with stainless steel wings, and syringes. We’re beginning to see more introducers for PICC and midline catheters."
According to Hadaway, the only area in which a safety device is unavailable is for the Seldinger technique. For Hadaway, though, it’s not the availability of the needles that is the problem,
"The biggest thing is for clinicians to start using the technology," she says.
But that is proving no small task. Because of the learning curve, many nurses are unwilling to switch to a safety device.
"I don’t think they understand the risk they are taking and exactly what can happen to them," she says. "There is a learning curve that goes along with switching devices, regardless if it is a safety device. In this particular case, I think they resist because they just don’t understand the risk of contracting a dangerous, potentially deadly bloodborne disease."
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