and “reporting”: “Most health centres have working
protocols to follow, including behaviour and monitoring
protocols in the event of biological accidents. Most health
centres have been given specific instructions on
prohibiting the recapping of needles. […] We are also
aware that verbal instructions were given regarding the
Directive, for example, not to cap needles, and the use of
prepared containers for disposing of sharps was insisted
upon – these specialist containers already existed prior
to the transposition of the Directive. In terms of
implementing these measures, we are only referring to
the public health sector; we do not have as much
information on the private health sector.”
the government [to] establish monitoring mechanisms
to verify the presence of safety equipment, in accordance
with the Directive, and that the equipment does not pose
any risks in itself.”
the “importance of understanding occupational risks
in employee training, as well as how to prevent them”
was emphasised.”
The status in Germany is encapsulated below: 2
Needlestick injuries fell steadily from 159 in 2007 to
109 in 2014 and to 95 in 2016.”
In all 3 settings [i.e. hospitals, doctors' surgeries and
care facilities] about half of the NSI did not occur during
the invasive procedure, but during the subsequent
disposal of the instruments. 30% of all NSI were caused
by needles for subcutaneous injections; in care facilities,
the proportion was above 50%.”
despite improved statutory regulation, needlestick
injuries and cuts are among the most frequent causes of
accidents in the health sector. […] Colleagues in the
hospitals note that steps are being taken to reduce risk
[and that] stress in the workplace continues to be the
prime risk factor for injury”. Concretely: 1) Injuries are
better recorded, leading to an increased number of
incidents reported; 2) Technical and organisational
risk minimisation measures are being implemented;
3) Guides and training measures helped to raise the
awareness of staff and managers. 4) A report on injuries
and their reasons is being produced in the hospitals at
least once a year, which, however, does not always imply
that counter-measures are taken.
For Germany both social partners indicated
particular challenges for handling medical sharps
in their disposal for doctors. 2
Risk assessments are being performed, but associated
measures are not being adequately implemented. Another
aspect is the inadequate supervision by monitoring
bodies – both [commerce] inspectorates and accident
insurance organisations, which are the bodies that need
to provide [a] more detailed specification of the disclosure
requirements associated with risk assessments.”
there should be a standard system of assessment/
evaluation. Because of Germany’s federal structure,
the results have to be laboriously collated. A national
register might perhaps be useful here.”
early suitable briefing and education of all apprentices
and employees” as a crucial element for training.
In Ireland: 2
information and awareness raising, training and
reporting are always challenges in an organisation
of such scale and complexity.”
The National Incident Management System (NIMS)
was introduced in 2015 by the State Claims Agency
(SCA). This requires all incidents to be reported through
a national centralised system and will ultimately
improve the quality of incident data collected(9). The
HSE has long been proactive in encouraging staff to
report all incidents – also all “near misses” and
incidents, even those that do not result in harm – and
4 | 2020 | hospitalpharmacyeurope.com
BOX 1
Costs of NSI to the individual and the organisation
Organisation Direct
• Absence of exposed
HCW during diagnosis/
treatment/follow-up/side
effects
• Testing for blood-borne
viral transmission
• Lawsuits and claims
• Compensation fees
• Investigation of incidents
• Post-exposure
prophylaxis Indirect
• Exposed HCW may
not be able to discharge
everyday responsibilities
in personal environment,
e.g. child minding
• Time diverted by
colleagues of the injured
HCW to managing, testing
and providing post-
exposure prophylaxis
for the colleague, and
to providing care for the
patient
• Reputational damage:
once lost, difficult to
regain
• Changing career/
qualifications
• Recruiting staff
replacement
Individual • Nurses/doctors may • Emotional disturbance
• Family stress/
The safety of
healthcare
workers is closely
linked to the
health of patients
Gabriella De Carli
have to be redeployed if
no definitive treatment is
available, in the interest of
patient safety
relationships
• Psychological damage
• Loss of job, loss of self-
confidence and loss of
confidence in institution
this is enshrined in the Corporate Safety Statement,
Sharps Policy and Incident Management Framework
and Guidance. The number of incidents reported
through the National Incident Management System
appears to have gradually reduced in the years since the
introduction of the Sharps legislation”, from 572 in 2012
to 408 in 2017.
in 2016 following a period of consultation with all key
stakeholders, including Unions, the Health Service
Executive approved and published a Policy on the
Prevention of Sharps Injuries. The purpose of the Policy
is to inform all HSE Managers (Responsible Persons) and
employees of the key issues to address when developing
safe work practices for the prevention of sharps injuries.
Under this Policy, HSE is committed to eliminating or
reducing the risk of exposure. […] The National Health
and Safety Function has developed a number of
resources to support managers in implementing the
policy.
a possible consideration was to the “development of
learning and education resources, such as e-learning
(e.g. to be delivered as part of blended learning
approach), which can be tailored for local implementation
by healthcare organisations across member states”.
And in France: 2
The staff representative bodies, and essentially in
the Health, Safety and Working Conditions Committee,
must ensure that the single document is up to date
as part of risk prevention. During nursing training,
time is spent on the provision of information. on [the]
prevention of accidents with exposure to blood.” Other
improvements are that staff now better respects
procedures, that the disposal of products used has
improved and that health and safety at work services
monitor the serological results of accidents at work,
with serological tests are carried out, even though those
declarations of accidents at work are not done in
a completely systematic manner.