NHS trusts 'ignoring' EU safety directive

With just a matter of months to comply, half of NHS trusts have not introduced safety needles

A MindMetre report reveals trusts are slow in adopting safety needles

The NHS is calling on medical device manufacturers to offer financial and factual support to trusts across the UK after a study revealed that two thirds of organisations have failed to introduce safety needles, despite a European Directive due to come into force next year.

Research commissioned by supplier, BD, and carried out by MindMetre, shows a worrying 49% of NHS trusts do not appear to have any form of ‘safety-only device’ policy in place, and only 32% have made a move to a partial or total safety needle system.

This is despite an EU Directive in 2010 which demanded improvements in health worker safety standards by May 2013. This order specifically referred to the focal role played by safety-engineered medical devices such as syringes, needles and catheters on reducing sharps injuries.

Across Europe, studies have indicated that the cost of dealing with needlestick injuries among healthcare professionals is greater than the additional cost of safety engineered devices designed to prevent them

In the UK alone, there are 100,000 so-called ‘needlestick’ incidents every year, leaving healthcare workers at risk of contracting up to 30 potentially life-threatening blood-borne pathogens such as Hepatitis B and HIV.

The MindMetre survey suggests problems with the switchover to safer working practices include a perceived lack of communication and knowledge sharing. However, there are also calls for the MedTech industry to better support trusts in making the argument for investment in safety devices, which can prove more costly than traditional equipment to procure.

A report on the research, entitled The Point of Prevention , states: “The majority [of those surveyed] - 75% - think that the move from zero or part use of safety devices to ‘safety devices only’ must be set out in a formal policy by each healthcare organisation in order to be effective. This transition can also be aided by device manufacturers. A total of 95% of respondents believe the latter should be offering support to healthcare organisations in the form of literature to build a business case. And 88% think that device manufacturers should be offering financial transition packages to help support healthcare organisations make the change to safety devices.”

A total of 95% of respondents believe device manufacturers should be offering support to healthcare organisations in the form of literature to build a business case and 88% think manufacturers should be offering financial transition packages to help support healthcare organisations make the change to safety devices

It adds: “A lack of communication and knowledge sharing is highlighted by respondents as an issue, with 83% feeling the new EU legislation has not been properly communicated to core practitioners such as nursing professionals in the NHS. A total of 80% believe it has not been properly communicated to blood sample collection and diagnosis departments in NHS hospitals, and 67% that it has not been properly communicated to health and safety or occupational health professionals in the NHS whose role is vital to see the implementation of safety devices policies more evenly spread across healthcare organisations and wards.”

There are currently a wide variety of safer sharps on the market, including spring-loaded retractable needles, needletip guards, puncture-resistant sharps containers, needle destructors, blunt sutures, and needle-free access valves for intravenous sets. These have been proven to reduce the rate of needlestick injuries in healthcare workers to nearly zero in some studies. And, while adoption means an initial financial outlay greater than that of the traditional devices, research shows that it reduces the huge costs associated with a needlestick injury and boosts staff morale.

These healthcare organisations want to create a safer environment for staff and clinicians that provides proper protection against injuries that cast a distressing shadow of worry over their daily tasks and, at worst, destroy lives

The report concludes: “Across Europe, studies have indicated that the cost of dealing with needlestick injuries among healthcare professionals is greater than the additional cost of safety engineered devices designed to prevent them.

“As awareness of the EU Directive increases, a proportion of healthcare organisations in both public and private sectors have rapidly identified a compelling business case for conversion to safety devices. They understand that needlestick injury costs can be substantial and have put in place risk assessment measures to help guide their transition. They also wish to avoid damaging legal action, costly compensation claims and adverse publicity, which undermine public confidence. Most importantly, these healthcare organisations want to create a safer environment for staff and clinicians that provides proper protection against injuries that cast a distressing shadow of worry over their daily tasks and, at worst, destroy lives.”

Commenting on the findings of the survey, Cliff Williams, co-chairman of the European Biosafety Network, said: “These findings add to the overwhelming body of research which shows that action must be taken now to protect vulnerable workers. People are suffering from injuries and emotional stress that can easily be prevented. The EU Directive, once implemented, will help to protect workers and patients. It is no longer acceptable to let these easily preventable injuries continue to occur. It is exploitation of hard-working people dedicated to caring for others."

It is no longer acceptable to let these easily preventable injuries continue to occur. It is exploitation of hard-working people dedicated to caring for others

Addressing the concerns about a lack of information and guidance, BD last year published a guide to help trusts understand the legislation. Johnny Lundgren, general manager for north west Europe, said: “Following the adoption of the new EU Directive on the prevention of sharps injuries, BD has distilled its experience - gained from working with a wide variety of forward-thinking healthcare organisations both across Europe and throughout the world – and has introduced a number of tools and initiatives to help healthcare organisations plan and implement their conversion strategies.

“We have published a set of management guides and recently launched a new Europe-wide safety website, both designed to help healthcare organisations improve healthcare worker safety, better understand this important legislation, and plan compliance.

“The safety website provides an overview of BD’s newly-launched healthcare worker safety programme, which takes a holistic approach to safety, providing tools and best practice advice on crucial elements such as health economics, risk assessment, conversion management and training. To help healthcare workers learn how to avoid sharps injuries, we, in conjunction with the Royal College of Nursing, are also bringing together a group of leading nursing professionals in and a series of educational workshops around the UK.

“The MindMetre research has shown that occupational health professionals are concerned that awareness of the new EU legislation is not yet sufficiently widespread. BD’s extensive set of tools are designed to support institutions as they work to achieve a straightforward, seamless and cost-effective transition to safer working practices and comply with the new EU Directive.”

Among the NHS organisations that are leading the way in embracing safer working practices is Winchester and Eastleigh Healthcare NHS Trust, which has introduced BD’s Eclipse Safety Needles at the Royal Hampshire County Hospital in Winchester and Andover War Memorial Hospital.

Trusts are using BD Eclipse safety devices to help cut down on sharps injuries

The trust’s head phlebotomist, Connie Hopper, said: “Following a spate of injuries we trialled the product and were impressed with how easily and effectively the safety cover was activated using a one-handed technique.

Many of us are guilty of shying away from change because of previous experience or fear of the unknown. However, change means we can improve safety and we should embrace it

“To see your staff going through the trauma of a needlestick injury is not pleasant. I always had prided myself in running a safe department, providing the best for patients and staff, and other than our choice of needles, we were achieving this.

“Many of us are guilty of shying away from change because of previous experience or fear of the unknown. However, change means we can improve safety and we should embrace it.”

Another user of BD’s Eclipse is Harrogate and District NHS Foundation Trust, which was one of the first NHS organisations to make the switch, in 2009, following a number of incidents. Its laboratory manager, Andrew Jackson, said of the challenges: “Since the needles are more expensive than the standard ones, we needed to submit a business case to the executive management team.

“At the time there were, on average, 27 sharps injuries of all causes each year at the trust and approximately 40-50% of these were venepunture-related. Each injury had cost the trust up to £415, meaning all sharps injuries were costing roughly £11,000 a year.

“The business case described how we had trialled the needles on the wards and that, as a result, there had been no venepuncture-related sharps injuries over the last 12 months. It included a comparison of the current spend on the standard needles with the same number of the BD Eclipse devices, and estimated that the trustwide switch would cost an additional £5,500 a year for the same number of needles. We concluded that by reducing venepuncture-related sharps injuries, based on the current sharps injury data, the project was, at the very least, likely to be cost neutral.”

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