Authors (including presenting author) :
Ng PY(1), Cheng KL(1), Lau KF(1), Lau KH(1), Lam WK(1), Li HL(1)
Affiliation :
(1) Infection Control Unit, Caritas Medical Centre
Introduction :
In year 2021, the incident rate of NSI/SI/BBF exposure in CMC reached a historical peak of 0.203 per 1000 patient bed days.
Remedial measures are required to control this occupational risks and prevention should be based on difference working lines.
Objectives :
1. To study the root causes of incidents in CMC
2. To generate the explicit and specific recommendations based on different risk factors identified
3. To promote the recommendations on safety use of needles and sharps
Methodology :
Each reported incident was interviewed by ICNs to study the root cause of incidents, so as to generate the explicit and specific recommendations. Upon review the method of risk analysis, 4 domains for risk stratification are employed to analysis the root causes, namely procedure, device, profession and workplace (table 1). Based on the root causes identified, explicit interventions were implemented for specific targets.
1. Results and findings would report to Hospital Safety Committee, Infection Control Committee, HCE, GMs, Departmental heads and infection control link staff.
2. Infection control talks and hands-on workshops were organized for all CMC staff who have to handle needles and sharps in September 2022. Root causes of incidents and risk assessment on environment setting, patient reassurance were educated as the key elements which influence the safety during needles and sharps handling. Staff was invited to manipulate the safety devices in hands-on workshops so to understand the activating method.
Result & Outcome :
During the review period, 67 incidents were reviewed. Needle stick injuries were reported with peak incidence in blood taking procedure (35%). Incidents involved phlebotomist doubled in 2021 (n=10), compared with 2020 (n=5).
1. Infection control talks and hands-on workshops were organized in September 2022 with over 150 staff members attended. Participants familiarized with the design and method of activation of safety devices. Awareness of handling sharps safely increased among staff
2. A half-yearly reassessment has been initiated to phlebotomist to review and sustain their safety awareness
3. The reusable ophthalmic device linked with repeated incidents were replaced with disposable
4. Training video on blood taking was produced to emphasize the assessment on patient’s condition and use of safety devices.
5. Incidents rate in 2022 dropped to 0.10 per 1000 patient bed days
